摘要
目的研究分析连续硬膜外麻醉和腰硬联合麻醉应用于剖宫手术的效果。方法选取我院2017年10月~2018年2月60例剖宫产择期手术患者,分为对照组与实验组,每组各30例,对照组给予腰硬联合麻醉,实验组给予连续硬膜外麻醉,观察对比两组产妇麻醉后的血压、心率、平均动脉压情况与术中不良反应的发生情况。观察两组患者胎儿娩出时间以及术中输液总量情况。结果对照组患者在麻醉后的血压为(101.60±15.48)mm Hg/(50.70±15.88)mm Hg,实验组患者为(119.63±5.09)mm Hg/(77.37±6.66)mm Hg,对照组患者的心率为(105.93±23.00)次/min,平均动脉压为(73.10±16.20)mm Hg,实验组患者的心率为(70.43±4.29)次/min,平均动脉压为(89.97±5.31)mm Hg。结果对照组患者的血压低于实验组、心率高于实验组,平均动脉压低于实验组。不良反应的发生率实验组为20.0%,对照组为86.7%,两组患者胎儿娩出时间以及术中输液总量对比,实验组患者胎儿娩出时间为(11.43±2.18)min,对照组患者为(25.42±3.26)min,输液总量实验组患者为(765.00±105.00)m L,对照组患者为(1568.00±267.00)m L,结果显示实验组患者胎儿娩出时间以及输液总量、不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论对剖宫产患者实施硬膜外麻醉可有效的降低产妇的不良反应,术中血压平稳,血流动力学稳定,胎儿娩出时间短,术中输液量少,安全性高,值得推广。
Objective To study and analyze the effect of continuous epidural anesthesia and combined spinal and epidural analgesia in Cesarean section. Methods 60 patients undergoing elective Cesarean section surgery in our hospi- tal from December 2017 to February 2018 were selected. They were divided into control group and experimental group, with 30 cases in each group. ASA grading was grade I - II. The control group was given combined spinal and epidural anesthesia. The experimental group was given continuous epidural anesthesia. The blood pressure, heart rate, mean ar- terial pressure and intraoperative adverse reactions after anesthesia were observed and compared in both groups of puerpera. The fetal delivery time and the total amount of infusion during the operation were recorded in both groups. Results In the control group, the systolic blood pressure after anesthesia was（101.60±15.48） mmHg, and the experimen- tal group was（119.63±5.09） mmHg. The diastolic pressure in the control group was（50.70±15.88） mmHg, and the exper- imental group was （77.37±6.66） mmHg. The results showed that the systolic and diastolic blood pressures in the control group were lower than those in the experimental group. In the control group, the heart rate was（105.93±23.00） beats/min. In the experimental group, the heart rate was（70.43±4.29） beats/min. The results showed that the heart rate in the con- trol group was higher than that in the experimental group. The mean arterial pressure in the control group was （73.10± 16.20） mmHg, and the experimental group was （89.97±5.31） mmHg. The results showed that the mean arterial pressure in the control group was lower than that in the experimental group, and the data were statistically significant（P〈0.05）. The incidence rate of adverse reactions such as nausea, vomiting, palpitation and chest tightness in both groups was 20.0% in the experimental group and 86.7% in the control group. The results showed that the incidence rate of adverse reactions in the experimental group was significantly less than the control group, and the data compared between the two groups were statistically significant （P〈O.05）. The fetal delivery time and total amount of intraoperative infusion were compared between the two groups. The fetal delivery time was（11.43±2.18） min in the experimental group and（25.42_± 3.26） min in the control group. The total amount of infusion was （765.00±105.00） mL in the experimental group and （1568.00±267.00） mL in the control group. The fetal delivery time and the total amount of infusion in the experimental group were lower than those in the control group, and the data compared between the two groups were statistically sig- nificant （P〈0.05）. Conclusion Epidural anesthesia for patients undergoing Cesarean section can effectively reduce ma- ternal adverse reactions and improve analgesic effect. Intraoperative blood pressure is stable and hemodynamics is sta- ble. At the same time, the operation time is not limited, the fetal delivery time is short, the amount of infusion during the operation is few, and the safety is high. It is worthy of promotion.
作者
彭海
包洪云
王丽芸
PENG Hai;BAO Hongyun;WANG Liyun(Department of Anesthesiology,No.464 Hospital of the PLA,Tianjin 300381,China)
出处
《中国现代医生》
2018年第21期127-130,共4页
China Modern Doctor
关键词
剖宫产
硬膜外麻醉
腰硬联合麻醉
效果
Cesarean section
Epidural anesthesia
Combined spinal and epidural analgesia
Effect
