目的：观察胶体液和平衡液预扩容对腰硬联合麻醉（CSEA）下行剖宫产术母婴的影响。方法：选择 CSEA 下行剖宫产手术100例，随机分为两组（n =50），A 组给予胶体液500 ml 进行预扩容，B 组给予平衡液500 ml 进行预扩容。分别于进手术室时、麻醉穿刺完成平卧后、胎儿娩出后及术毕记录产妇 BP、HR，于胎儿娩出时取产妇动脉（MA）、脐动脉（UA）血查血气。结果：术中 A、B 组 BP 均降低，HR 均升高，最低收缩压和舒张压 A 组都高于 B 组；最高心率、麻黄碱平均需要量及低血压发生率 A组低于 B 组，产妇的氧分压 A 组高于 B 组。结论：在 CSEA 下行剖宫产术如预先行胶体液扩容能很好改善产妇的血流动力学及微循环，还能增加胎盘血流，稳定母婴内环境，进而提高剖宫产妇和胎儿的安全性。%Objective To compare and observe the influence of colloid solution and ringer's solution pre - dilatation on mother and in-fant received optional cesarean section with combined spinal epidural anesthesia(CSEA). Method 100 cases of optional cesarean sections with CSEA were selected and randomly divided into two groups(n = 50). Group A adopted 500 ml colloid solution pre - dilatation and Group B adopted 500 ml lactated ringer's solution pre - dilatation. Delivery women's BP and HR were recorded in different periods(pre -operation,lying down after anesthesia puncture,after the baby was delivered and post - operation). Arterialblood specimen of the mothers (MA)and umbilical artery blood(UA)were taken to have blood gas checked after fetal disengagement. Results BP of both group A and B decreased while HR increased during the operation. The lowest SBP and DBP of group A were higher than that of group B. The highest HR,average requirement of metaraminol and incidence of hypotension of group A were lower than that of group B. Delivery women's PO2 of group A were higher than that of group B. Conclusion Colloid solution priming is able to better improve Delivery women's hemodynamics received cesarean sections with CSEA and Delivery women's circulation. Meanwhile,it is favorable to accelerate uterine placenta blood flow and maintain homeostasis of mother and infant. Thus,safety of parturient women with cesarean section and their babies can be further im-proved.
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