EFFECT OF LEFT-LATERAL POSITION ON MATERNAL HEMODYNAMICS DURING RITODRINE TREATMENT IN COMPARISON WITH SUPINE POSITION
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概要
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切迫早産例の ritodrine投与時にみられる循環系への副作用軽減に対する母体左側臥位の有用性を明らかにすべく, また仰臥位における妊娠子宮による caval compressionが本剤投与によりいかなる影響を受けるかにつき検討し, 仰臥位低血圧発症に関する要因を探つてみた. 29例の切迫早産例を対象とし, ritodrine投与前と投与時における仰臥位と左側臥位での心機能を Impedance cardiogramを用い測定し, 同時に右上肢血圧をも測定した. (1) 仰臥位での ritodrine投与に従い, 当初増加していた stroke volume(SV), cardiacoutput (CO)も漸次低下し, ほぼ投与前値に戻つた状態にて左側臥位をとらせたところ (n=14), 70%の症例に heart rate (HR)が減少し, 同時に SV, COの増加がみられた. しかしHRが無変化のものでは, 心機能にも変動が認められない. (2) ritodrine投与時の状態において, 体位変換に伴う心機能の変動幅を投与前の体位変換による変動幅と比較検討した結果, 投与中は左側臥位への変換により, より著しいHRの減少とSVの増加が認められた. 以上のことより, ritodrine投与時の副作用防止策として, 左側臥位での管理が適正であることを明らかとし, 同時に仰臥位では, ritodrine投与により弛緩した妊娠子宮の腹部大血管への圧迫が, 大動脈より大静脈血管により強く影響することが示唆された.
- 1991-06-01
著者
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Park Yong
Department of Genetic Engineering, Kyungpook National University
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HIDAKA Atsuo
Department of Obstetrics and Gynecology Osaka City University Medical School
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Park Yong
Department Of Applied Biological Chemistry Faculty Of Agriculture Shizuoka University
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Park Yong
Department Of Obstetrics And Gynecology Osaka City University Medical School
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Park Yong
Department of Advanced Materials, Engineering for Information and Electronics, Kyung Hee University, Yongin 446-701, Korea
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