摘要
目的探讨腰硬联合麻醉在妊娠期高血压疾病(hypertensive disorders of pregnacy,HDP)产妇剖宫产术中的应用价值。方法选取90例接受剖宫产术的HDP产妇随机分为观察组(n=45)和对照组(n=45)。对照组采用连续硬膜外麻醉处理,观察组采用腰硬联合麻醉处理。比较两组产妇麻醉药用量、麻醉起效时间、麻醉开始至胎儿娩出时间,麻醉前(T1)、麻醉后10 min(T2)、胎儿娩出(T3)及手术结束(T4)时产妇的心率(heart rate,HR)、舒张压(diastolic blood pressure,DBP)和收缩压(systolic blood pressure,SBP),两组产妇不良反应发生情况。结果观察组T2、T3、T4时刻和对照组T2、T4时刻HR均与T1时刻比较差异均无统计学意义(P> 0.05),对照组T3时刻HR高于T1时刻(P=0.001);两组T2、T3、T4时刻DBP和SBP均低于T1时刻(P <0.05),观察组T3、T4时刻HR低于对照组,SBP、DBP水平均高于对照组(P <0.05)。观察组麻醉起效时间、麻醉开始至胎儿娩出时间短于对照组(P <0.05)。观察组不良反应发生率低于对照组(χ~2=4.444,P=0.035)。结论腰硬联合麻醉用于HDP剖宫产安全有效,有助于维持HDP剖宫产产妇血压及心率水平稳定。
Objective To explore the value of combined spinal and epidural anesthesia in cesarean section for HDP. Methods 90 cases of HDP women undergoing cesarean section were randomly divided into observation group(n=45) and control group(n=45).The control group was treated with continuous epidural anesthesia, and the observation group was treated with combined spinal and epidural anesthesia. The two groups of maternal anesthetics, the onset time of anesthesia, the time from the start of anesthesia to the delivery of the fetus were compared, The HR, DBP and SBP of the parturients at before anesthesia(T1), 10 min after anesthesia(T2), fetal delivery(T3) and end of operation(T4) were compared. The incidence of maternal adverse reactions in the two groups. Results There was no significant difference in HR between the observation group at T2, T3, T4 and the control group at T2, T4 and T1(P > 0.05). The HR at T3 of the control group was higher than that at T1(P=0.001). The DBP and SBP at T2, T3 and T4 were lower than those at T1(P < 0.05).The HR at T3 and T4 in the observation group was lower than that in the control group, and the SBP and DBP levels were higher than those in the control group(P < 0.05). The onset time of anesthesia and the time from the start of anesthesia to the delivery of the fetus in the observation group were shorter than those in the control group(P < 0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group(χ^2=4.444, P=0.035). Conclusion Combined spinal and epidural anesthesia is safe and effective for HDP cesarean section, which helps to maintain stable blood pressure and heart rate in HDP cesarean section.
作者
林冬丽
LIN Dongli(Department of Anesthesiology,Chaoyang District Dafeng Hospital of Shantou,Shantou Guangdong 515154,China)
出处
《中国卫生标准管理》
2020年第23期54-56,共3页
China Health Standard Management
关键词
腰硬联合麻醉
硬膜外麻醉
妊娠期高血压疾病
剖宫产术
安全性
应用价值
combined spinal and epidural anesthesia
epidural anesthesia
hypertension during pregnancy
cesarean section
safety
application value
