[关键词]
[摘要]
卡前列素氨丁三醇作为人工合成的前列腺素PGF2α衍生物,可有效增强子宫收缩,减少产后出血,在剖宫产手术当中被广泛应用。但其不良反应如血压升高、心率增快、恶心呕吐、胃痛腹痛、胸闷、呼吸困难和潮热等也常常影响到围术期麻醉安全。对预防卡前列素氨丁三醇不良反应药物的研究进展进行综述,为剖宫产术中安全应用卡前列素氨丁三醇提供依据。对症处理中,抗胆碱类药物、止吐药、降压药等单独或联合应用均可对卡前列素氨丁三醇不良反应有一定预防作用;而麻醉药物右美托咪定、丙泊酚、舒芬太尼、曲马多、地佐辛等由于具有镇静、镇痛等作用,低剂量应用也能够有效预防剖宫产术中卡前列素氨丁三醇引发的不良反应。但各种药物之间缺乏统一的比较标准与效价比分析,后期研究可综合考虑各药物的作用机制与剂量,提出更为优化的预防方案。
[Key word]
[Abstract]
As a synthetic prostaglandin PGF2α derivative, carprostatin butanol can effectively enhance uterine contraction and reduce postpartum hemorrhage, and is widely used in caesarean operation. But its adverse reactions, such as hypertension, increased heart rate, nausea and vomiting, stomach pain, chest tightness, dyspnea, and hot flashes often affect the safety control of perioperative anesthesia. Research progress on drugs of preventing adverse reactions introduced by carprostatin butanol during cesarean section are reviewed in this paper, providing the basis for safe application of hemabate in cesarean section. Single or combined application of anticholinergic medications, antiemetic, and antihypertensive drugs all have a preventive effect on the adverse reaction of carprostatin butanol. While the anesthetics, dexmeimidine, propofol, sufentanil, tramadol, and dextrin can also effectively prevent adverse reaction of carprostatin butanol in caesarean section due to their sedative and analgesic effects. But there is no unified comparative standard and titer ratio analysis among various drugs. Futher studies should focus on the mechanism and dosage of these drugs and put forward more optimized prevention strategy.
[中图分类号]
[基金项目]
国家自然科学基金资助项目(31760327)