妊娠合并风湿性心脏病患者行剖宫产术的围期麻醉处理  

The Perioperative Anesthesia Management of Cesarean Section on Pregnancy Complicated With Rheumatic Heart Disease

作　　者：崔巍[1] 李卫[1] 董艳红[1] 

机构地区：[1]赤峰学院附属医院麻醉科,内蒙古赤峰024000

出　　处：《内蒙古医学杂志》2012年第9期1058-1060,共3页Inner Mongolia Medical Journal

摘　　要：目的:总结妊娠合并风湿性心脏病患者剖宫产术的麻醉处理。方法:选择28例妊娠合并瓣膜性心脏病患者剖宫产术的麻醉相关资料,26例采用连续硬膜外麻醉,小量、分次注入2%利多卡因与罗哌卡因合剂。2例心功能Ⅲ级以上者采用全身麻醉。结果:所有产妇术中均无麻醉并发症发生,新生儿全部存活。1例术后3 h后出现心衰肺水肿,经积极抢救,痊愈出院。结论:瓣膜性心脏病孕妇实施剖宫产术麻醉,术前应充分准备以尽可能控制和改善心衰,根据患者心功能选择合理的麻醉方法和药物;术中根据患者瓣膜病变类型调整心率和输液量,合理应用强心、利尿和血管活性药;术后应施予有效镇痛。Objective：Summarize the perioperative anesthesia management of cesarean section on pregnancy complicated with rheumatic heart disease.Method：Anesthesia-related data of cesarean section on 28 pregnant women with valvular heart disease were selected.26 patients were performed with continuous peridural anesthesia and injected with multiple low dose of 2% lidocaine-ropivacaine mixture.Two cases above cardiac function III were operated with general anesthesia.Results：No anesthetic complications occurred in all surgeries and all newborns survived.One patient presented heart failure and pulmonary edema three hours after surgery and recovered after positive rescue.Conclusion：In the anesthesia of cesarean on pregnant women with valvular heart disease,sufficient preparations should be prepared before surgery to control and improve cardiac function in patients with heart failure as far as possible,choose proper anesthesia and drugs according to patients＇ heart function;adjust heart rate and fluid volume according to the type of valvulopathy of patients,use cardiotonic,diuretic,and vasoactive drugs reasonably during surgery;apply effective analgesia after surgery.

关 键 词：妊娠 风湿性心脏病 剖宫产术 麻醉 

分 类 号：R768.1[医药卫生—耳鼻咽喉科] R644[医药卫生—临床医学]