好腰硬联合麻醉在妊娠高血压综合征剖宫产产妇中的应用效果观察

陈　锴; 张兆伟; 秦妮娜

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湖南师范大学学报医学版 ›› 2018, Vol. 15 ›› Issue (3) : 63-65.

临床医学

好腰硬联合麻醉在妊娠高血压综合征剖宫产产妇中的应用效果观察

陈　锴，张兆伟，秦妮娜

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The Application Effect Spinal-epidural Combined with Anesthesia in the Treatment of Pregnancy - induced Hypertension in Cesarean Section

Chen Kai, Zhang Zhao-wei, Qin Ni-na

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目的：研究腰硬联合麻醉在妊娠高血压综合征剖宫产产妇中的应用效果。方法：选取2013年3月~2016年2月我院收治的88例妊娠高血压综合征患者，根据随机数字法分为观察组和对照组，44例每组。对照组采取连续硬膜外麻醉，观察组采取腰硬联合麻醉。比较两组产妇麻醉效果，血流动力学指标，新生儿Apgar评分及胎儿娩出时间。结果：观察组的麻醉药总量、麻醉起效时间、痛觉最高平面显著少于对照组［（1.87±0.23）mL、（10.43±1.23）min、（11.48±1.76）min比（15.32±2.41）mL、（15.76±1.56）min、（15.34±1.21）min］。观察组的肌松效果显著优于对照组。观察组的收缩压、舒张压、心率水平显著低于对照组［（118.45±12.32）mmHg，（73.48±7.02）mmHg，（74.53±7.21）次/min比（130.98±13.21）mmHg，（82.98±10.43）mmHg，（82.79±8.37）次/min］。两组新生儿Apgar评分比较无显著差异，观察组的胎儿娩出时间显著短于对照组［（22.54±2.34）min比（38.87±4.57）min］。结论：腰硬联合麻醉能减少妊娠高血压综合征剖宫产产妇的痛苦，稳定产妇的血流动力学指标，确保产妇及胎儿的安全，麻醉效果良好。

Abstract

Objective To study the application effect spinal-epidural combined with anesthesia in the treatment of pregnancy-induced hypertension in cesarean section. Methods 88 patients with pregnancy-induced hypertension from March 2013 to February 2016 were selected in our hospital, those patients were randomly divided into observation group and control group according to random number, 44 cases in each group. Continuous epidural anesthesia were used in the control group, the observation group were taken spinal-epidural combined with anesthesia. The anesthetic effect, hemodynamics, neonatal Apgar score and fetal delivery time were compared between the two groups. Results The total anesthetic volume, anesthesia onset time and pain level in the observation group were significantly lower than the control group ［ (1.87±0.23) mL, (10.43±1.23) min, (11.48±1.76) min VS (15.32±2.41) mL, (15.76±1.56) min, (15.34±1.21) min］. The muscle relaxation effect of the observation group was significantly better than the control group. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate in the observation group were significantly lower than those in the control group ［ (118.45±12.32) mmHg, (73.48±7.02) mmHg, (74.53±7.21) time / min VS (130.98±13.21) mmHg, (82.98±10.43) mmHg, (82.79±8.37) times / min］. There was no significant difference in Apgar scores between the two groups. The time of delivery of the fetus in the observation group was significantly shorter than the control group ［ (22.54±2.34) min vs (38.87±4.57) min］. Conclusion Spinal-epidural combined with anesthesia can reduce the pain of cesarean section in pregnancy - induced hypertension syndrome, stabilize the hemodynamics index of maternal and ensure the safety of mother and fetus. The anesthesia effect is good.

关键词

腰硬联合麻醉

/ 妊娠高血压综合征 / 剖宫产术

Key words

spinal-epidural combined with anesthesia

/ pregnancy-induced hypertension / cesarean section

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陈　锴，张兆伟，秦妮娜.

好腰硬联合麻醉在妊娠高血压综合征剖宫产产妇中的应用效果观察

[J]. 湖南师范大学学报医学版. 2018, 15(3): 63-65

Chen Kai, Zhang Zhao-wei, Qin Ni-na.

The Application Effect Spinal-epidural Combined with Anesthesia in the Treatment of Pregnancy - induced Hypertension in Cesarean Section

[J]. Journal of Hunan Normal University(Medical Science). 2018, 15(3): 63-65

参考文献

［1］伍茵, 周昌菊. 妊娠期糖代谢异常的诊断和对妊娠结局的影响［J］. 湖南师范大学学报 (医学版), 2012, 9(2): 67-70.

［2］禹彬, 宋伟奇. 妊娠期高血压病合并HELLP综合征临床分析［J］. 中国妇幼保健, 2013, 28(36): 5955-5956.

［3］姜海利, 王欣. 剖宫产术后阴道分娩的产程时限研究［J］. 中国全科医学, 2016, 19(28): 3439-3443.

［4］ Vaishnav SB, Vaishnav B, Desai KN, et al. Critically ill obstetric patients requiring mechanical ventilation in rural western India: A retrospective analysis［J］. Natl Med J India, 2016, 29(2): 68-72.

［5］ Inangil G, Deniz S, Kurt YG, et al. How important is the butyrylcholinesterase level for cesarean section［J］. Pregnancy Hypertens, 2016, 6(1): 26-29.

［6］沈启云. 不同麻醉方式在妊高压综合征患者剖宫中的效果对比观察及对认知功能的影响研究［J］. 湖南师范大学学报 (医学版), 2017, 14(3): 144-147.

［7］卢家¿. 妊娠合并重症心脏病患者剖宫产麻醉处理［J］. 实用妇产科杂志, 2015, 31(6): 414-416.

［8］李黎, 姜丽华, 顾士敏, 等. 静脉预注甲氧明对剖宫产腰-硬联合麻醉低血压的防治效果［J］. 临床麻醉学杂志, 2012, 28(10): 1001-1003.

［9］邵兆军, 张朝巍, 谭建强, 等. 罗哌卡因复合小量芬太尼用于妊高征孕妇剖宫产术腰麻效果观察［J］. 天津医药, 2012, 40(11): 1172-1173.

［10］ Hilton G, Daniels K, Carvalho B. Simulation Study Assessing Healthcare Provider's Knowledge of Pre-Eclampsia and Eclampsia in a Tertiary Referral Center［J］. Simul Healthc, 2016, 11(1): 25-31.

［11］陈茜.76例妊娠高血压疾病的临床诊治分析［J］. 重庆医学, 2013, 42(16): 1880-1881.

［12］范翠芳, 张正娥, 明蕾, 等. COOK双球囊与缩宫素促宫颈成熟并引产的对照研究［J］. 重庆医学, 2012, 41(36): 3820-3822.

［13］罗芳, 费志医, 白帆, 等. 妊娠高血压综合征合并宫颈感染对妊娠结局及术后感染的影响分析［J］. 中华医院感染学杂志, 2014, 24(4): 988-990.

［14］ Ciach K, Niedoszytko M, Abacjew-Chmylko A, et al. Pregnancy and Delivery in Patients with Mastocytosis Treated at the Polish Center of the European Competence Network on Mastocytosis (ECNM) ［J］. PLoS One, 2016, 11(1): e0146924.

［15］ Kominiarek MA, Chauhan SP. Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines［J］. Am J Perinatol, 2016, 33(5): 433-441.