摘要
目的探讨全身麻醉在妊娠合并严重血小板减少产妇剖宫产术时对母儿结局的影响。方法选取2003年1月至2008年12月在北京大学人民医院产科因血小板计数〈50×10^9／L、孕周〉35周而住院分娩的单胎妊娠产妇65例，随机选取其中35例采用全身麻醉行剖宫产分娩（全身麻醉组），30例采用局部浸润麻醉行剖宫产分娩（局部麻醉组）。观察全身麻醉组产妇麻醉诱导至胎儿娩出时间，并比较两组产妇从切开皮肤至胎儿娩出的时间、手术时间、麻醉前后血氧饱和度、术中出血量、新生儿Apgar评分、新生儿出生体重、脐动静脉血气分析结果。结果全身麻醉组产妇麻醉诱导至胎儿娩出时间平均为（9．7±3．5）min。（1）全身麻醉组产妇从切开皮肤至胎儿娩出的时间[（7．7±2．5）min]显著短于局部麻醉组[（12．5±3．0）min]，两组比较，差异有统计学意义（P〈0．01）；但总手术时间两组比较，差异无统计学意义（P〉0．05）。（2）麻醉前后血氧饱和度在全身麻醉组产妇分别为（97．9±1．3）％及（98．1±1．1）％，局部麻醉组产妇分别为（98．3±1．2）％及（98．6±0．8）％，两组分别比较，差异均无统计学意义（P〉0．05）。（3）全身麻醉组及局部麻醉组产妇剖宫产术中出血量[分别为（471±245）及（452±213）ml]比较，差异无统计学意义（P〉0．05）。（4）两组新生儿1分钟Apgar评分比较，差异无统计学意义（P〉0．05）；5分钟Apgar评分均为10分。（5）局部麻醉组有2例发生新生儿轻度窒息，全身麻醉组无新生儿窒息发生；两组新生儿出生体重比较，差异无统计学意义（P〉0．05）。（6）两组新生儿血气分析结果比较，差异无统计学意义（P〉0．05）。结论对妊娠合并严重血小板减少产妇选择全身麻醉行剖宫产术是安全的，对母儿结局无不良影响。
Objective To investigate the effect of general anesthesia on pregnancy women with thrombocytopenia and neonate during cesarean section（CS）. Methods Sixty-five singleton pregnant women with low platelet count （ 〈 50 × 10^9/L） and gestation 〉 35 weeks were allocated into general anesthesia group （35 cases ） and local anesthesia group （30 cases ） randomly. The time from skin incision to fetal delivery, the oxyhemoglobin saturation （ SO2 ） before and after anesthesia, the blood loss during operation, Apgar scores at 1 min, birth weight, umbilical cord blood gas analysis were recorded. Results The mean time from anesthesia induction to fetal delivery was （9. 7 ± 3.5 ） minutes in general anesthesia group. The time from skin incision to fetal delivery in general anesthesia group [ （7.7 ± 2. 5 ）minutes ] was shorter than that in local anesthesia group [ （ 12. 5 ± 3.0 ） minutes, P 〈 0. 01 ], while the operation time had no significant differences. There were no significant difference for the value of SO2 before and after general anesthesia or local anesthesia（P 〉0. 05 ）. There was no significant difference for the blood loss [ （471 ± 245 ）ml vs. （452 ± 213 ） ml, P 〉 0.05 ], Apgar scores at 1 minute, birth weight and umbilical cord blood gas analysis between the two groups （P 〉 0. 05 ）. There had two infants with blue asphyxia in local anesthesia group while no infant with asphyxia in general anesthesia group. Conclusion General anesthesia is safe to pregnant women with thrombocytopenia during CS.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2009年第9期665-668,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
剖宫产术
血小板减少
妊娠并发症
血液
麻醉
全身
妊娠结局
Cesarean section
Thrombocytopenia
Pregnancy complications, hematologic
Anesthesia, general
Pregnancy outcome
