摘要
目的研究腰麻、硬膜外阻滞和腰-硬联合阻滞应用于瘢痕子宫剖宫产患者的疗效以及对产妇血流动力学、麻醉效果和新生儿Apgar评分的影响。方法 90例ASAⅠ~Ⅱ级瘢痕子宫妊娠剖宫产患者随机分为腰麻组(SA组)、硬膜外阻滞组(EA组)和腰-硬联合阻滞组(CSEA组)3组,每组30例。监测3组患者麻醉前后MAP、HR,并评估麻醉效果以及记录3组新生儿娩出后Apgar评分。结果 3组MAP麻醉后10min SA、CSEA组血压明显低于麻醉前(P<0.05),EA组血压无明显变化;麻醉后3组心率变化差异无统计学意义。麻醉效果优良率SA组(96.7%)、CSEA组(100.0%)优于EA组(66.7%)(P<0.05)。3组新生儿Apgar评分无显著性差异(P>0.05)。结论腰-硬联合阻滞既有较好的麻醉效果,又保证了产妇及围产儿的安全,是值得临床广泛应用的麻醉方法。
Objective TTo study the effect of combined spinal epidural anesthesia and spinal epidural anesthesia on cesarean section in patients with uterine scar, and its effect on hemodynamics, anesthetic effect and neonatal Ap-gar score. Methods A total of 90 patients with cesarean section of ASA Ⅰ-Ⅱ scar pregnancy were randomly divided into spinal anesthesia group （group SA）, epidural block group （group EA） and spinal epidural block group （group CSEA）, each group of 30 cases. Monitored the operation of the three groups before and after anesthesia MAP, HR, and to evaluate the anesthetic effect and recorded the three groups of neonatal Apgar score. Results Three groups of MAP in group SA, group CSEA blood pressure was significantly lower than before anesthesia （P〈0.05）, group EA blood pressure did not change significantly after anesthesia, the heart rate of the three groups was not statistically sig-nificant. The anesthetic effect rate of group SA （96.7%） and group CSEA （100%） was better than that of group EA （66.7%） （P〈0.05）. There was no significant difference in Apgar score among the three groups （P〉0.05）. Conclusion Spinal -epidural anesthesia has better effect, and can ensure the safety of maternal and perinatal. It is worthy of clini-cal application of anesthesia.
作者
张一军
骆喜宝
廖年有
管飞杰
刘炳祥
林庆秋
葛鹏飞
王菲
Zhang Yijun Luo Xibao Liao Nianyou et al(Yongfu, County Peopled Hospital of Guangxi, Guilin 541200)
出处
《中国现代医药杂志》
2017年第5期11-13,共3页
Modern Medicine Journal of China
基金
广西壮族自治区卫生和计划生育委员会计划课题(编号:Z2015246)
