L_(3-4)间隙25G细针不同入路单次腰麻用于剖宫产术的临床研究  

Clinical Study of Single Spinal Anesthesia by 25G Fine Needle through Different Approaches at L_(3-4) Interval in Cesarean Section

作　　者：方军[1] 王胜斌[1] 

机构地区：[1]安徽医科大学附属安庆医院麻醉科,安徽安庆246003

出　　处：《贵阳医学院学报》2015年第10期1135-1138,共4页Journal of Guiyang Medical College

摘　　要：目的:比较腰椎固定间隙(L3-4)不同入路单次腰麻用于剖宫产术的临床效果。方法:90例行剖宫产术产妇,随机均分为3组,均选择从L3-4间隙入路;A组为25G细针正中入路直刺法(细针与脊柱垂直入路),B组为25G细针正中入路斜刺法(针尾向骶尾端,细针与脊柱成75°夹角),C组为传统针内针与脊柱垂直穿刺入路;对3组患者的麻醉时间、穿刺时间、不良反应以及术后随访情况进行比较。结果:B组和C组麻醉效果明显优于A组(P<0.05);A组术中疼痛,牵拉反应明显高于其他两组(P<0.05),C组穿刺时间明显长于A组与B组(P<0.05);术后随访中,头痛发生率各组比较差异无统计学意义(P>0.05),腰痛发生率C组明显高于A组和B组(P<0.05),各组均未出现下肢痛症状。结论:L3-4间隙25G细针直入法与脊柱倾斜入路,穿刺方便,麻醉效果确切,不良反应与术后并发症少。Objective： To investigate the clinical effect of single spinal anesthesia by different ap- proaches through L3-4 interval in treatment of cesarean section. Methods： Ninety cases of cesarean section were randomly divided into 3 groups, 30 cases in each group. In group A ： 25 G fine needle was used by vertical approach ; In group B ： 25 G fine needle was used by inclined approach （ the needle tail pointing to the sacral and fine needle forming 75 degree angle with spine） ; In group C ： ordinary acu- puncture was used by acupuncture approach. Then the anesthesia duration, puncture time, adverse re- action and postoperative follow-up survey were compared between group A, B and C. Results： Com- pared with group B and group C, the anesthetic effect of group A was significantly better （ P 〈 0.05 ）. The pain and stretch reaction in group A were significantly stronger than those in group B and group C （P 〈 0. 05 ）. The puncture time in group C was significantly longer than that in group A and group B （ P 〈 0.05 ）. In postoperative follow-up, there were no statistical differences in the incidence of head- ache （P 〉 0.05 ）. The incidence of lumbago in group C was significantly higher than its counterparts in group A and group C. There appeared no lower limb pain in each group. Conclusion： In spinal an- esthesia through the interval （ L3 -4 ） , the 25 G fine needle by inclined approach is convenient in cesar- ean section, which shows its certain analgesic effect, less adverse reaction and less complication.

关 键 词：剖宫产术 细针 腰椎麻醉 

分 类 号：R719.8[医药卫生—妇产科学]