目的:观察麻黄碱联合去氧肾上腺素预防剖宫产术中低血压的效果和安全性。方法:选择足月、单胎、需择期行腰麻-硬膜外联合麻醉产妇150例,随机分为观察组、对照1组和对照2组各50例。观察组采用麻黄碱4mg+去氧肾上腺素50μg、对照1组单用麻黄碱8mg、对照2组单用去氧肾上腺素100μg预防剖宫产术中低血压,3组均于麻醉成功后经静脉泵入。监测用药后2min、5min、10min 3组平均动脉压、心率、胎心率变化及不良反应发生情况。胎儿娩出即刻抽取产妇动脉血及新生儿脐周动脉血和脐静脉血进行血气分析。结果:(1)3组术中平均动脉压趋于稳定,与基础值比较均差异不显著(P>0.05)。用药后5min、10min,观察组和对照1组心率、胎心率,均显著高于基础值(P<0.05);对照2组心率显著低于基础值(P<0.05),胎心率与基础值比较差异不显著(P>0.05)。(2)3组除HCO-3外,血气分析各指标比较均差异显著(P<0.05)。观察组和对照2组脐动脉、脐静脉血的pH和碱剩余(BE),均显著高于对照1组(P<0.05);观察组脐动脉血的BE亦显著高于对照2组(P<0.05)。观察组脐动脉、脐静脉血的二氧化碳分压(PCO2)、乳酸水平均显著低于对照1组(P<0.05),氧分压(PO2)水平显著高于对照1组(P<0.05);观察组脐动脉、脐静脉血的乳酸水平均显著高于对照2组(P<0.05),脐动脉血的PO2水平亦显著高于对照2组(P<0.05)。(3)3组新生儿1min和5min Apgar评分比较,均差异不显著(P>0.05)。(4)观察组恶心、呕吐发生率显著高于对照2组(P<0.05),对照1组恶心、呕吐发生率非常显著高于对照2组(P<0.01)。结论:采用麻黄碱联合去氧肾上腺素预防剖宫产术中低血压,较单用麻黄碱或去氧肾上腺素效果好,且较安全。 Objective: To observe the effect and safety of ephedrine combined with phenylephrine in preventing hypotension during cesarean section. Methods: A total of 150 cases of full-term, single-fetus and elective epidural anesthesia were randomly divided into observation group, control group 1 and control group 2, 50 cases each. Ephedrine 4mg + phenylephrine 50μg in the observation group, 8mg ephedrine alone in the control group 1, and 100μg phenylephrine alone in the observation group. The three groups were all treated with intravenous pump Into. The mean arterial pressure, heart rate, fetal heart rate and adverse reactions in 2 groups were monitored 2min, 5min and 10min after treatment. Fetal delivery immediately extracted maternal arterial blood and neonatal umbilical artery blood and umbilical blood gas analysis. Results: (1) The average arterial pressure in the three groups tended to be stable, with no significant difference compared with the baseline (P> 0.05). The heart rate and fetal heart rate of the observation group and the control group 1 were significantly higher than those of the baseline (P <0.05) at 5 and 10 minutes after treatment. The heart rate of the control group 2 was significantly lower than the baseline (P <0.05) The difference was not significant (P> 0.05). (2) In addition to HCO-3, the blood gas analysis of the three groups were significantly different (P <0.05). The values ​​of BE and BE in the umbilical artery and umbilical vein of the observation group and the control group were significantly higher than those in the control group 1 (P <0.05). The BE of the umbilical artery in the observation group and the control group were also significantly higher than those in the control group 2 <0.05). The levels of PCO2 and lactic acid in the umbilical artery and umbilical vein of the observation group were significantly lower than those of the control group 1 (P <0.05) and the levels of PO2 were significantly higher than those of the control group 1 (P <0.05). The levels of lactate in the umbilical artery and umbilical vein of the observation group were significantly higher than those of the control group (P <0.05), and the levels of PO2 in the umbilical artery were significantly higher than those of the control group (P <0.05). (3) There was no significant difference in Apgar scores at 1 minute and 5 minutes between 3 groups (P> 0.05). (4) The incidence of nausea and vomiting in observation group was significantly higher than that in control group 2 (P <0.05). The incidence of nausea and vomiting in control group 1 was significantly higher than that of control group 2 (P <0.01). Conclusion: Ephedrine combined with phenylephrine prevents hypotension during cesarean section, which is more effective than ephedrine or phenylephrine.