摘要
目的:探讨重度子痫前期孕妇与健康孕妇在腰硬联合麻醉下行剖宫产术发生低血压的风险。方法:收集2016年8月至2017年8月入院的40例重度子痫前期孕妇作为重度子痫前期孕妇组,并收集同期入院的240例健康产妇作为健康产妇组,比较两组产妇麻醉期间指标、新生儿体重、低血压发生率、麻醉期间SBP、DBP、MAP、HR与其他不良反应。结果:重度子痫前期孕妇组利多卡因用量、输液总量、麻黄素剂量与新生儿体重均显著性低于健康孕妇组,低血压发生率显著性高于健康孕妇组;SBP、DBP与MAP基础值、麻醉后最低值、最低血压下降程度与基础值-最低血压值均显著性高于健康孕妇组;HR基础值、麻醉后最低值、最低心率下降程度、基础值-最低心率值与麻醉后最高值均显著性高于健康孕妇组,最高心率上升程度与最高心率-基础值均显著性低于健康孕妇组;恶心率显著性高于健康孕妇组,存在显著性差异(P<0.01);术后疼痛率明显高于健康孕妇组,存在明显差异(P<0.05)。结论:重度子痫前期孕妇在腰硬联合麻醉下行剖宫产术发生低血压的风险较高,因此需要调整麻醉剂量,加强术中输液管理。
Objective： To investigate the risk of hypotension in cesarean section of pregnant women with severe preeclampsia and healthy pregnant women under combined spinal epidural anesthesia. Methods： 40 pregnant women with severe preeclampsia were enrolled from August 2016 to August 2017 as pregnant women with severe preeclampsia and 240 healthy pregnant women were enrolled as healthy maternal groups. The maternal anesthesia period was compared between the two groups,Neonatal weight,hypotension incidence,anesthesia SBP,DBP,MAP,HR and other adverse reactions. Results： The dosage of lidocaine,the total amount of infusion,the dose of ephedrine and the weight of neonatal were lower than those of healthy pregnant women,and the incidence of hypotension was significantly higher than that of healthy pregnant women group.SBP,DBP and MAP The baseline values,the lowest values after anesthesia,the lowest blood pressure drop and the basal value-the lowest blood pressure values were significantly higher than those in the healthy pregnant women group; HR basal value,lowest postnesthesia,lowest heart rate decline,basal value-lowest heart rate（ P〈0.01）. The significant difference between the two groups was higher than that of the healthy pregnant women group,and the highest heart rate was higher than that of the healthy pregnant women group（ P〈0.01）. The postoperative pain rate was significantly higher than that of healthy pregnant women group（ P〈0.05）. Conclusion： Pregnant women with severe preeclampsia have a higher risk of developing low blood pressure during cesarean section under combined spinal epidural anesthesia. Therefore,it is necessary to adjust the anesthetic dose and strengthen the management of intraoperative infusion.
出处
《河北医学》
CAS
2018年第1期16-20,共5页
Hebei Medicine
基金
山东省自然科学基金
(编号:ZR2014HL108)
关键词
重度子痫前期
腰硬联合麻醉
剖宫产
低血压
Severe preeclampsia
Combined spinal and epidural anesthesia
Cesarean section
Hypotension
