摘要
目的:分析硬膜外麻醉和腰硬联合麻醉对择期剖宫产产妇凝血功能及疼痛影响.方法:回顾性选取本院2021年2月-2023年2月收治的剖宫产产妇110例临床资料,依据麻醉方式分为硬膜外组和联合组各55例,研究过程中硬膜外组脱落2例,共纳入53例;联合组脱落3例,共纳入52例.硬膜外组给予硬膜外麻醉,联合组给予腰硬联合麻醉,对比两组麻醉指标、血流动力学指标、凝血功能指标、疼痛情况、新生儿情况及不良反应发生率.结果:联合组输液量(1026.37±65.44ml)、出血量(902.34±87.26ml)及手术时间(104.27±9.34min)均低于硬膜外组(1789.56±70.22ml、902.34±87.26ml、131.26±12.58min),平均动脉压(110.27±5.68mmHg)、心率(86.27±4.57次/min)水平均高于硬膜外组(95.46±4.03mmHg、75.49±3.14次/min),活化部分凝血活酶时间(26.03±2.14s)、凝血酶原时间(11.98±0.54s)水平均低于硬膜外组(29.63±3.28s、13.66±1.03s),纤维蛋白原(2.93±0.32g/L)水平高于硬膜外组(2.61±0.26g/L),视觉模拟评分(1.32±0.49分)及Ramsay镇静评分(2.43±0.13分)均低于硬膜外组(2.72±0.85分、3.14±0.46分),不良反应发生率(9.6%)低于硬膜外组(26.4%)(均P<0.05).结论:椎管内麻醉可有效减轻剖宫产产妇疼痛,保持产妇凝血功能及血流动力学稳定,但腰硬联合麻醉效果优于硬膜外麻醉.
Objective:To analyze the efects of epidural anesthesia and the combined epidural anesthesia used during the elective cesarean section of women on their coagulation function and pain degree.Methods:The clinical data of 110 women with the elective cesarean section from February 2021 to February 2023 were selected in this study retrospectively.According to the method of anesthesia,these women were divided 55 women with the epidural anesthesia in group A and 55 women with the combined epidural anesthesia epidural in group B.There were 2 women had dropped off in group A,and a total of 53 women were included for analysis finally.There were 3 women in group B had dropped out,and a total of 52 women were included for analysis finally.The walues of anesthesia indexes,hemodynamic indexes and coagulation function indexes,the pain and the neonatal situations,and the incidence of adverse reactions of the women were compared between the two groups.Results:The infusion volume(1026.37±65.44 ml),the bleeding volume(902.34±87.26 ml)and the operation time(104.27±9.34 min)of the women in group B were significantly lower than those(1789.56±70.22 ml,902.34±87.26 ml and 131.26±12.58)of the women in group A The values of the mean arterial pressure(110.27±5.68 mmHg)and the heart rate(86.27±4.57 beats/min)of the women in group B were significantly higher than those(95.46±4.03 mmHg and 75.49±3.14 beats/min)of the women in group A The walues of activated partial thromboplastin time(26.03±2.14s)and the prothrombin time(11.98±0.54s)of the women in group B were significantly lower than those(29.63±3.28s and 13.66±1.03s)of the women in group A.The level of fibrinogen(2.93±0.32 g/L)of the women in group B was significantly higher than that(2.61±0.26 g/L)of the women in group A.The scores of visual analogue scale(1.32±0.49 points)and Ramsay sedation(2.43±0.13 points)of the women in group B were significantly lower than those(2.72±0.85 points and 3.14±0.46 points)of the women in group A.The incidence of adverse reactions(9.6%)of the women in group B was significantly lower than that(26.4%)of the women in group A(all P<0.05).Conclusion:Intraspinal anesthesia can efectively during the cesarcan section of the women can reduce their pain degree,and can keep the stabilizations of their coagulation function and hemodynamics,but the anesthesia efect of the combined epidural anesthesia is significantly better than that of the epidural anesthesia.
作者
盛伟伟
王宁
SHENG Weiwei;WANG Ning(Shulan(Hangzhou)Hospital,Hangzhou,Zhejiang Province,310000;The Second Affiliated Hospital of School of Medicine,Zhejiang University,Hangzhou,Zhejiang Province,310009)
出处
《中国计划生育学杂志》
2024年第1期232-236,共5页
Chinese Journal of Family Planning
关键词
剖宫产术
硬膜外麻醉
腰硬联合麻醉
凝血功能
疼痛
Caesarean section
Epidural anesthesia
Combined epidural anesthesia
Coagulation function
Pain
