摘要
目的:探究超声定位下椎管内麻醉在肥胖型妊娠期高血压疾病(PIH)产妇剖宫产术效果.方法:随机数表法将本院2020年1月-2022年7月就诊的96例肥胖型PIH产妇分为观察组与对照组各48例,分别接受超声定位下椎管内麻醉或传统方法椎管内麻醉.对比两组穿刺情况、麻醉效果等指标.结果:观察组穿刺成功率(100%)与对照组(89.6%)无差异(P>0.05),穿刺相关并发症发生率(4.2%)低于对照组(20.1%),腰椎间隙定位时间(1.50±0.36 min)、麻醉穿刺时间(4.40±1.17min)、起效时间(11.70±2.24min)及穿刺次数(1.12±0.30次)均小于对照组(4.12±1.18min、7.25±1.20min、16.00±2.35min、1.84±0.50次),麻醉效果I级(97.9%)高于对照组I级(85.4%);两组麻醉用药后10min血压均下降但观察组变化幅度小于对照组;两组术后12h血清皮质醇、C肽、晚期氧化蛋白产物水平均上升但观察组变化幅度小于对照组(均P<0.05).两组新生儿脐动脉血血气指标、娩出后1min、5minApgar评分均无差异(P>0.05).结论:超声定位下椎管内麻醉用于肥胖型PIH产妇剖宫产术能提高穿刺成功率,减少相关并发症,对产妇血流动力学及应激激素影响小,麻醉效果好.
Objective:To explore the efect of intraspinal anesthesia by ropivacaine combined with lidocaine under ultra-sound guidance used in caesarean section of obese women with pregnancy-induced hypertension(PIH).Methods:96 obese women with PIH who wanted cacsarean section were divided into two groups(48 cases in cach group)by the ran-dom number table method from January 2020 to July 2022.The women in the observation group received the intraspi-nal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section,and the women in the observation group rceived the traditional intraspinal anesthesia by ropivacaine combined with lidocaine.The puncture condition and the anesthesia effect of the women were compared between the two groups.Results;There was no significant difference in the puncture suecess rate(100%vs.89.6%)of the women between the two groups(P>0.05).The incidence of puncture related complications(4.2%)of the women in the observation group was signifi-cantly lower than that(20.1%)of the women in the control group.The lumbar space positioning time(1.50±0.36 min),the anesthesia puncture time(4.40±1.17 min),the onset time of anesthesia(11.70±2.24 min)and the puncture number(1.12±0.30 times)of the women in the control group were significantly lower than those(4.12±1.18 min,7.25±1.20 min.16.00±2.35 min and 1.84±0.50 times)of the women in the control group.The rate of anesthetic ffet of grade I(97.9%)of the women was significantly higher than that(85.4%)of the women in the control group.The blood pressure value of the women in the two groups at 10 minutes after anesthesia had decreased significantly,but the change range of which of the women in the observation group was significantly less than that of the women in the control group.The levels of serum cortisol,C-peptide and advanced oxidation protein products of the women in the two groups in 12 hours after operation had increased significantly,but the change ranges of which of the women in the observation group were significantly less than those of the women in the control group(all P<0.05).There were no significant differences in the umbilical artery blood gas indexes values and Apgar scores at 1min and 5min after delivery of the newborns between the two groups(P>0.05).Conclusion:Ultrasound-guided intravertebral anesthesia by ropiv-acaine combined with lidocaine during caesarean section of the obese women with PIH can improve the success rate of puncture,reduce the related complications,and which has less influence on the maternal hemodynamics and stress hor-mones,and with good anesthesia effect.
作者
刘小军
余功
LIU Xiaojun;YU Gong(Chun'an County Maternal and Child Health Care Hospital,Hangzhou Zhejiang Province,311700)
出处
《中国计划生育学杂志》
2024年第1期68-72,共5页
Chinese Journal of Family Planning
关键词
肥胖型妊娠期高血压疾病
剖宫产
椎管内麻醉
超声定位
穿刺
血流动力学
应激反应
麻醉效果
Obesity complicated with pregnancy induced hypertension
Caesarean section
Intravertebral anesthesia
UIltrasound-guided location
Puncture
Hemodynamics
Stress response
Effect of anesthesia
