Hypertonic Saline Liquid Crystal Gel Compound Pre-expansion Of Cesarean Section Related Physiological Function In Patients

Objective:To research and application at home and abroad has been committed to the appropriate dose of hypertonic salt mixture liquid in order to maintain the pre-expansion of maternal hemodynamic stability and minimal impact on the newborn. The purpose of this study of hypertonic saline hydroxyethyl starch 40 injection (hereinafter referred to as hom) Pre-expansion of the cesarean section maternal hemodynamics, electrolyte and coagulation function. Thus propose a new program of the best pre-expansion. What is the liquid to further explore how the amount ofpre-expansion of the best interests of mother and child.Method:The Second Affiliated Hospital of Zhengzhou University in the 2009-2010 period of hospitalization, to be in the combined spinal and epidural anesthesia for cesarean section in singleton pregnancies full-term pregnant women,90 cases were randomly divided into three groups of 30 cases. A group of pre-infusion of hypertonic saline hydroxyethyl starch 40 injection (HSH) 4ml/kg. Group B Pre-Input 6% hydroxyethyl starch (wanwenl30/0.4) 10 ml/kg. C group pre-enter the compound sodium chloride solution,10 ml/kg. Three groups of fluid were administered 30 minutes before anesthesia enter. Anesthesia of choice is a combined spinal and epidural anesthesia. After the pre-anesthesia well, with combined spinal and epidural needle, through the L2,3 gap for Spinal puncture to determine cerebrospinal fluid outflow at a slow speed (about 1ml/15s) injection of local anesthetic of 0.5%ropivacaine 1.5-2ml after the epidural catheter insertion. Technique using liquid compound sodium chloride to maintain until the completion of surgery. Intraoperative continuous monitoring of heart rate (heart rate, HR), electrocardiogram (Electrocardiogam, ECG) mean arterial pressure (MAP), and record the pre-expansion before (TO), after the pre-expansion (T1), anesthesia after administration 5min (T2), lOmin (T3),20min (T4) and the surgery completed (T5) maternal MAP, HR. At TO, T1, T3, T4, T5 blood collection time points measured HCT, blood coagulation function (PT, APTT, Fib) and electrolytes (Na+, Cl-, K+). Record three groups of patients have completed surgery fluid volume and urine output. Finally, three groups of newborns Apgar score comparison.Results:1 three groups of patients generally no significant difference:Operative time, blood loss, no significant difference.2. MAP changes:Between the two groups:T0,T1 time point in each group, the difference was not statistically significiant(P>0.05).T3,T4,T5 timepoint, C group and A,Bgrop,the difference was statistically significant(P<0.05).T2T3 time point,A,B group, the diffierence was statistically significant(P<0.05),over time, A,B group, the difference was not statistically significiant(P>0.05).Comparison group:A,B group in the T1 time point compared with To time point, the difference was statistically significant(P<0.05),C group T3,T4,T5 time point, compared with TO time, the difference was statistically significant(P<0.05).3.HCT change:Between the two groups:To time in the three group, the difference was not statistically significiant(P>0.05).In T1, T5 time, A,B group and C group, the difference was statistically significant(P<0.05). Group comparison:in T1, T5 time point, A,B group with To time point, the difference was statistically significant(P<0.05).C group at timr points T1 and To time, the difference was statistically significant(P<0.05).4. Coagulation changes:PT:Between the two groups:In T1, T5 time, C and A,B group, the difference was statistically significant(P<0.05).A,B group at each time point, the difference was not statistically significiant(P>0.05).Group comparison:T1, T5 time point, A,B group compared with To, the difference was statistically significant(P<0.05).APTT:between the two groups:The time To Between the groups, the difference was not statistically significiant(P>0.05).In T1, T5 time points, C and A,B group, the difference was statistically significant(P<0.05).A,B between the two groups, the difference was not statistically significiant(P>0.05).Group comparison:In A,B group T1, T5 compared with To, a significant difference (P<0.05).5. Electrolyte changes:5.1 Na+ between the two groups:To time point between the two groups:the difference was not statistically significiant(P>0.05). T1, T5 time point, B, C group and A group, the difference was statistically significant(P<0.05).Group comparison:T1,T5 time point, A group and time point To, the difference was statistically significant(P<0.05).5.2 K+ between the two groups:At each time point,the group K+,the difference was not statistically significiant(P>0.05).Group comparison:T1, T5 time point, To in each groups, the difference was statistically significant(P<0.05).5.3 Cl- group comparison:between the two groups:the time point To between the three groups, the difference was not statistically significiant(P>0.05).In T1,T5 time point, B, C group and A group, the difference was statistically significant(P<0.05).6. Three groups of newborns 1 min and 5 min APGAR score changes: Three groups of newborns 1 min and 5 min APGAR score in each groups, the difference was not statistically significiant(P>0.05).Conclusion:The use of hypertonic salt solution on the cesarean section before the compound can increase the mother's pre-expansion of the effective circulating blood volume to maintain the maternal hemodynamic stability, effective prevention of hypotension occurs during surgery is beneficial to increase placental blood flow, improving fetal oxygen supply, improve the perioperative maternal and child security.