硬膜外分娩镇痛转行硬膜外剖宫产麻醉失败的相关因素分析  

Analysis of the Related Factors of Failure to Convert Labor Epidural Analgesia to Epidural Anesthesia for Cesarean Section

作　　者：付英勇 徐学芹 杨微 付崇勇 刘芳婷[2] 袁红斌[2] 

机构地区：[1]山东省聊城市东昌府人民医院麻醉科,山东聊城252000 [2]第二军医大学长征医院麻醉科,上海200003

出　　处：《现代生物医学进展》2014年第8期1539-1541,1549,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30901470)

摘　　要：目的:探讨采用硬膜外分娩镇痛中途转行硬膜外剖宫产麻醉失败的相关因素并对其进行分析。方法:选择来我院进行硬膜外分娩镇痛转而形硬膜外剖宫产麻醉的产妇218例,根据硬膜外麻醉失败的定义将其划分为成功组和失败组,对两组的一般资料、产程中的平均动脉压、硬膜外分娩镇痛情况分别进行比较分析。结果:成功组192例,失败组26例,两组产妇在一般资料上无差异(P>0.05),在转行剖宫产前成功组平均动脉压显著低于失败组(P<0.05),补救给药的次数上成功组显著低于失败组(P<0.05),在镇痛持续时间上成功组显著少于失败组(P<0.05)。结论:影响硬膜外剖宫产麻醉失败的危险因素是分娩镇痛时需要补救给药的次数增加以及镇痛所持续的时间延长,对于出现此类危险因素的产妇,应改变剖宫产麻醉方式,以最大限度地降低剖宫产麻醉的失败率,这对于母婴并发症的减少起着积极的作用。Objective： to discuss the relevant factors of the failure to transit from the Epidural Labor analgesia to the epidural anesthesia for cesarean section. Methods： Choose 218 examples of pregnant women who come to our hospital and underwent the transition from the Epidural Labor analgesia to the epidural anesthesia for cesarean section. Divide them into 2 groups （group of success and group of failure） according to the definition of the Epidural Anesthesia Failure. Results： Comparing the general data, the mean arterial blood pressure during delivery and the condition of epidural pain between the two groups, it can be found that the two groups have no difference in the general data（P〉0.05）. However, when it comes to the mean arterial blood pressure, the number of remedies and the time of continuous pain, the group of success is obviously lower than the group of failure （P〈0.05）. Conclusions： The dangerous factors related to the failure of anesthesia for cesarean delivery include the increasing number of remedies and the increasing time of the continuous pain. In order to decline the potential failure of Anesthesia for cesarean delivery as well as the outbreak of some disease of mothers and infants, we should change the way of anesthesia for cesarean delivery in operation on the women with delivery failure as soon as possible.

关 键 词：分娩镇痛 剖宫产麻醉 硬膜外镇痛 麻醉失败 

分 类 号：R614[医药卫生—麻醉学] R719[医药卫生—外科学]