血小板减少症孕妇剖宫产手术不同麻醉方法的比较  

Comparison of different anesthesia methods in pregnant women with thrombopenia under cesarean section

作　　者：杨华[1] 张厚忠[1] 柴红梅[1] 刘爽[1] 

机构地区：[1]吉林大学第二医院麻醉科,吉林长春130041

出　　处：《中国妇幼保健》2009年第23期3226-3227,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨不同麻醉方法用于血小板减少症孕妇剖宫产手术的麻醉效果、并发症的发生以及麻醉药对新生儿的影响。方法:回顾性分析合并血小板减少症行剖宫产手术256例孕妇的临床资料。结果:21.48%行腰硬联合麻醉(CSEA),69.94%用腰硬联合包但只做单次腰麻(SSA),8.58%行全麻。所有孕妇无椎管内血肿等并发症发生,麻醉效果满意。全麻组除术前已确诊死胎3例外,余新生儿均成活,但新生儿Apgar评分与椎管内麻醉组相比差异有统计学意义(P<0.01),CSEA组与SSA组相比新生儿Apgar评分差异无统计学意义(P>0.05)。结论:对无明显出血病史的血小板减少症孕妇选择单次腰麻是可行的。Objective： To explore the effects of different anesthesia methods and the occurrence of complications in pregnant women with thrombopenia under cesarean section and the effect of anesthetic on neonates. Methods： Clinical data of 256 cases with thrombopenia receiving cesarean section were analyzed retrospectively. Results： 21.48% of the pregnant women received combined spinal epidural anesthesia （CSEA）, 69.94% of the pregnant women received subarachnoid space block anesthesia （SSA） and 9.37% of the pregnant women received general anaesthesia. No complications occurred and the effects of anesthesia were satisfactory. Except 3 cases of fetal death before cesarean section in general anesthesia, the rest of neonates survived, but there was significant difference in Apgar score between general anesthesia and spinal block anesthesia （P 〈0.01 ） , while there was no difference in Apgar score between CSEA group and SSA group （ P 〉 0.05 ） . Conclusion： It is feasible to select subarachnoid space block anesthesia in pregnant women with thrombopenia which have no obvious bleeding history.

关 键 词：血小板减少症 孕妇 剖宫产术 

分 类 号：R714.254[医药卫生—妇产科学] R719.8[医药卫生—临床医学]