剖宫产术时两种麻醉方式的对比研究  

Comparison of the effects of general and epidural anesthesia for cesarean section on fetuses

作　　者：朱春仙[1] 陈宏[1] 黄荷凤[2] 

机构地区：[1]浙江大学医学院附属妇产科医院麻醉科,杭州310006 [2]浙江大学医学院附属妇产科医院妇产科,杭州310006

出　　处：《中华妇产科杂志》2005年第4期253-255,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的通过对剖宫产术时全身麻醉与硬膜外阻滞的对比研究,探讨两种麻醉方式对胎儿的安全性。方法足月单胎妊娠行择期剖宫产的产妇中,选择血小板计数<50×109 /L的病例行全身麻醉(全麻组),血小板≥50×109 /L者行硬膜外阻滞(硬膜外组),两组各30例。两组产妇均在胎儿娩出时抽取脐动、静脉血,进行血气分析。分别记录两组胎儿娩出时间、手术时间、1分钟和5分钟Apgar评分,并比较这些指标和血气分析指标。结果全麻组和硬膜外组新生儿1分钟Apgar评分分别为(9 5±1 1)、(9 8±0 7 )分, 5分钟Apgar评分均为10分,两组比较,差异均无统计学意义(P>0 05)。胎儿娩出时脐动、静脉血的pH值在全麻组分别为7 31±0 06和7 31±0 04,硬膜外组分别为7 28±0 07和7 32±0 05,两组比较,差异均无统计学意义(P>0 05)。结论全身麻醉和硬膜外阻滞均可安全地用于剖宫产。Objective To determine the safety of regular doses of general anesthesia and epidural anesthesia on neonates delivered by cesarean sections. Methods Singleton pregnant women for whom elective cesarean sections were planned after 37 gestational weeks were allocated to general anesthesia group (platelet count<50×109/L) or epidural anesthesia group (platelet count≥50×109/L). Arterial and venous samples were withdrawn from the doubly clamped umbilical cord segment at delivery for the pH, bicarbonate, PO_2, and PCO_2. All delivery times, birth weights, and Apgar scores at 1 min, 5 min were recorded. Results The mean Apgar score at 1 min for the general anesthesia group was 9.5±1.1 and ~9.8± 0.7 for the epidural anesthesia group, without significant difference(P>0.05). The Apgar scores at ~5 min of all newborns were 10. The mean umbilical arterial and venous blood pH for the general anesthesia group were 7.31±0.06, 7.31±0.04, and 7.28±0.07, 7.32±0.05 for the epidural anesthesia group respectively. No significant difference was found between the two groups (P>0.05). Conclusions Our prospective study suggests that mode of anesthesia does not influence significantly the outcome of newborn infants delivered by elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections safely.

关 键 词：对比研究 麻醉方式 APGAR评分 硬膜外阻滞 全身麻醉 胎儿娩出时间 择期剖宫产 血小板计数 单胎妊娠 血气分析 手术时间 分析指标 0.05 静脉血 统计学 安全性 全麻 新生儿 pH值 剖官产 产妇 组分 

分 类 号：R614[医药卫生—麻醉学] R722.12[医药卫生—外科学]