【摘要】 目的　研究硬膜外麻醉下行剖宫产术中输注琥珀明胶对母儿血浆内皮素和降钙素基因相关肽浓度的影响。方法　 2 0个病例随机分为两组 :对照组 (Ⅰ ) ,输乳酸钠林格液 15ml·kg- 1 ·h- 1 ;试验组组 (Ⅱ ) ,输注琥珀明胶 10ml·kg- 1 ·h- 1 ,分别输上述液体 5 0 0ml后均改为输林格氏液 ,速率10ml·kg- 1 ·h- 1 。于麻醉诱导前 (T1 )、胎儿娩出时 (T2 )分别采母体静脉血 5ml,胎儿娩出尚未建立呼吸时采脐动、静脉血各 5ml。采用放射免疫法 ,检测血浆内皮素 (ET)和降钙素基因相关肽 (CGRP)的浓度。结果　与T1 比较 ,T2 时Ⅱ组母体血浆ET浓度降低 ,而CGRP浓度则升高 (P <0 0 5或0 0 1) ,Ⅰ组则无明显差异 ;与Ⅰ组比较 ,T2 时Ⅱ组母体血浆ET浓度降低 ,而CGRP浓度升高 (P <0 0 5或 0 0 1) ;Ⅱ组脐动、静脉血浆ET浓度均降低 (P <0 0 5 ) ,CGRP浓度无明显变化。结论　剖宫产术中输注琥珀明胶能增加器官、组织的灌注量 ,改善母体微循环 ,有利于增加子宫胎盘血流。更多还原

【Abstract】 Objective To determine the effect of succinylated gelatin (gelofusine) administration on maternal and fetal plasma endothelin(ET) and calcitonin gene related peptide(CGRP)levels during caesarian section under epidural anesthesia Methods Twenty healthy parturients were randomly allocated into two groups: group Ⅰ (control group) received lactated Ringer’s solution 15ml·kg -1 ·h -1 and group Ⅱ received gelofusine 10ml·kg -1 ·h -1 After 500ml infusion of either lactated Ringer’s solution or gelofusine, each parturient received lactated Ringer’s solution 10ml·kg -1 ·h -1 during operation No premedication was given Epidural block was performed at L 2 3 2% lidocaine (without adrenaline) was given The height of block was controlled at T 6 8 During operation parturients received no oxygen inhalation, narcotics or sedatives Maternal blood samples were taken before epidural anesthesia ( T 1 ) and at delivery(T 2), umbilical cord venous and arterial blood samples were also obtained immediately after delivery before the first cry of newborns for determination of plasma concentration of ET and CGRP Results There was no significant difference in the concentration of ET and CGRP between T 1 and T 2 in group Ⅰ(P>0 05) The maternal plasma CGRP level was significantly higher(P<0 05), while ET level was significantly lower at T 2 than those at T 1 in group Ⅱ The maternal plasma ET concentration was significantly lower and CGRP level significantly higher at T 2 in group Ⅱ than those in group Ⅰ ET level in umbilical cord venous and arterial blood samples was also lower in group Ⅱ than that in group Ⅰ There was no significant difference in umbilical cord blood level of CGRP between the two groups Conclusions Gelofusine administration can significantly increase organ and tissue perfusion of blood, improve microcirculation and uteroplacental blood flow during caesarian section under epidural anesthesia更多还原