陈其琼

[摘要] 目的 對比限制性输液与开放性输液在产科麻醉中的应用效果。方法 方便选取2015年1月—2016年12月该院产科接受的麻醉产妇80名作为研究对象。采用随机数表法将其分为观察组与对照组，对照组40名产妇实施开放性输液常规静脉液体复苏，观察组40名产妇实施限制性输液，比较两组产妇临床相关指标及不良结局发生情况。结果 观察组产妇MAP[（61.3±5.4）mmHg vs （75.6±4.3）mmHg]、CVP[（8.7±3.6）mmHg vs （11.2±5.3）mmHg]、PaO2[（190.4±12.5）mmHg vs （153.5±11.4）mmHg]、HR[（63.1±6.4）次/min vs （71.2±5.4）次/min]、总出血量[（127.5±15.3）mL/h vs 186.9±16.7）mL/h]、总输液量[（1 923.5±153.4）mL vs （3 652.4±125.3）mL]等指标均明显优于对照组，差异有统计学意义（P<0.05）；并且观察组产妇输液相关费用、住院时间明显低于对照组，差异有统计学意义（P<0.05）；观察组产妇术后生活质量评分明显高于对照组[（33.8±14.5）分 vs （29.5±13.7）分]，差异有统计学意义（P<0.05）。结论 在产科麻醉中采用限制性输液方法可有效改善产妇临床相关指标，降低产妇住院时间及输液相关消费，具有临床应用及推广价值。

[关键词] 限制性输液；开放性输液；产科麻醉；应用价值

[中图分类号] R656 [文献标识码] A [文章编号] 1674-0742（2017）08（a）-0066-03

[Abstracts] Objective This paper tries to compare the effect of restrictive infusion and open infusion in obstetric anesthesia. Methods 80 cases of narcotics from January 2015 to December 2016 in this obstetrics and gynecology department were convenient collected and divided into the observation group and the control group by random number table method， with 40 cases in each group. The control group was treated with open venous fluid resuscitation. The observation group was treated with restrictive infusion. The clinical indexes and adverse outcomes were compared between the two groups. Results In the observation group and the control group， the MAP were [（61.3±5.4）mmHg vs （75.6±4.3）mmHg]， CVP were [（8.7±3.6）mmHg vs （11.2±5.3）mmHg]， PaO2 were [（190.4±12.5）mmHg vs（153.5±11.4）mmHg]， HR were[（63.1±6.4）times/min vs （71.2±5.4）times/min]， the total amount of bleeding were [（127.5±15.3）mL/h vs 186.9±16.7）mL/h]， the total amount of infusion were [（1 923.5±153.4）mL vs 3652.4±125.3）mL] and other indicators were significantly better than the control group， and the differences were statistically significant（P<0.05）； and maternal transmission liquid related costs， hospitalization time of the observation group were significantly lower than the control group， which has statistical significance； maternal postoperative quality of life score of the observation group was significantly higher than the control group [（33.8±14.5）points vs （29.5±13.7）points]（P<0.05）， with statistical significance（P<0.05）. Conclusion The use of restrictive infusion in obstetric anesthesia can effectively improve the clinical indicators of maternal， reduce maternal hospital stay and infusion related consumption， so it is worth clinical application and promotion.

[Key words] Restrictive infusion； Open infusion； Obstetric anesthesia； Application valueendprint

静脉输液液体复苏是麻醉苏醒期最长应用的措施之一，但不同静脉输注方式可产生完全不同的治疗效果，限制性输液是近年来临床提出的新型输液概念[1]，是指机体处于未控制性出血的失血性休克时，可通过控制液体输入的容量与速度保持患者机体平均动脉压水平在不用升压药物的前提下，便可维持在一个满足重要器官血流灌注且能有效降低出血量的理想水平，进而达到减少止血过程中输血量、输液量的目的[2-3]。近年来不断的临床研究与验证性实验表明，限制性输液是一种安全、有效的输液方式，但对其在临床各科室中的实际应用效果，仍缺乏大量的研究与报道，该组研究通过对2015年1月—2016年12月该院产科麻醉中的产妇80名进行随机对照研究，对比限制性输液与开放性输液在产科麻醉中的应用效果，现报道如下。

1 资料与方法