摘要
目的探讨与分析腰-硬联合麻醉对于糖尿病孕妇在剖宫产过程中麻醉处理效果的差异性。方法方便选取该院2015年9月—2016年9月收治的糖尿病初产妇120例,根据体重指数是否超过25 kg/m2随机分为肥胖组和非肥胖组,每组60例,在手术当中采取腰-硬联合麻醉,观察两组空腹血糖、输液量、胰岛素抵抗指数、低血压发生率、持续时间以及患者不良反应,糖耐量、产后出血发生率等变化情况。结果观察组中患者在进行手术麻醉过程中除空腹血糖,输液量(1 540±459.00)m L、胰岛素抵抗指数为(7.32±3.12)、低血压发生率25%以及持续时间(35.3±3.50)min均明显高于对照组输液量(1 235±410.60)m L、胰岛素抵抗指数为(6.22±1.77)、低血压发生率12%,持续时间(20.0±3.10)min,上述指标对比,其差异有统计学意义(P<0.05);两组均有不良反应发生,观察组糖耐量试验2 h血糖(mmol/L)及产后出血率(%)均较对照组低。结论糖尿病孕妇剖宫产手术当中采取腰麻-硬膜外联合麻醉技术容易出现低血压,并且肥胖糖尿病孕妇更容易发生,改善低血压情况比较困难。
Objective To study and analyze the anesthesia management effect of combined spinal-epidural anesthesia for delivery women with diabetes in the cesarean section. Methods Convenient selection 120 cases of diabetes primipara from September 2015 to September 2016 were selected and divided into two groups with 60 cases in each according to whether the weight index was more than 25 kg/m2, the patients adopted the combined spinal-epidural anesthesia in operation, and the fasting blood glucose, transfusion amount, insulin resistance index, incidence rate of hypotension, duration, adverse reactions and incidence rate of postpartum hemorrhage of the two groups were observed. Results The transfusion amount, insulin resistance index, incidence rate of hypotension and duration in the observation group were obviously higher than those in the control group, [(1 540± 459.00)m L,(7.32±3.12), 25%,(35.3±3.50)min vs(1 235± 410.60)m L,(6.22±1.77), 12%,(20.0±3.10)min], and the differences between groups were statistically significant(P<0.05), and there were adverse reactions in the two groups, and the 2h blood glucose(mmol/L)and postpartum hemorrhage rate(%)in the observation group were lower than those in the observation group. Conclusion The combined spinal-epidural anesthesia for delivery women with diabetes in the cesarean section is easy to cause hypotension, especially for the obesity delivery women with diabetes,and it is difficult for them to improve the hypotension.
出处
《中外医疗》
2017年第12期13-15,共3页
China & Foreign Medical Treatment
关键词
麻醉
糖尿病孕妇
剖宫产
临床疗效
Diabetes delivery women
Cesarean section
Clinical curative effect
