连续硬膜外麻醉与腰硬联合麻醉对剖宫产产妇围术期皮质醇和血浆D-D水平的影响  

Effects of continual epidural anesthesia and combined spinal epidural anesthesia on plasma cortisol and D-dimer levels of women during cesarean section

作　　者：刘琼[1] 许莉[1] 许铿[1] 卢秀英[1] 

机构地区：[1]海口市妇幼保健院麻醉科,海南海口570102

出　　处：《中国妇幼保健》2016年第6期1285-1287,共3页Maternal and Child Health Care of China

基　　金：海南省自然科学基金项目(813266)

摘　　要：目的探究连续硬膜外麻醉(CEA)和腰硬联合麻醉(CSEA)对剖宫产产妇围术期皮质醇和血浆D-二聚体(DD)水平的影响。方法选择剖宫产产妇69例随机分为观察组36例和对照组33例,观察组产妇给予CSEA,对照组产妇给予CEA,检测并比较两组产妇围手术期内皮质醇、D-D水平变化情况。结果围手术期两组产妇皮质醇水平在胎儿娩出时、手术结束时显著高于麻醉前,且对照组产妇水平显著高于观察组(P<0.05);两组产妇D-D水平在手术结束时、术后24 h较麻醉前均显著升高,且对照组D-D水平在术后24、72 h均显著高于观察组(P<0.05)。结论与CEA相比,CSEA不仅可以抑制剖宫产术中血清皮质醇的分泌,且可以抑制术后血浆D-D水平的升高,更有利于改善术后的血液高凝状态。Objective To explore the effects of continual epidural anesthesia（ CEA） and combined spinal epidural anesthesia（ CSEA） on plasma cortisol and D-dimer（ D-D） levels of women during cesarean section. Methods Sixty-nine women prepared for a cesarean section were selected and randomly divided into observation group（ 36 cases） and control group（ 33 cases）. The women in observation group were treated with CSEA,while the women in control group were treated with CEA. The changes of perioperative plasma cortisol and D-D levels in the two group were detected and compared. Results The levels of plasma cortisol at childbirth and the end of the surgery were significantly higher than that before anesthesia,the levels in control group were statistically significantly higher than those in observation group（ P〈0.05）. The levels of D-D at the end of the surgery and 24 hours after surgery were significantly higher than that before anesthesia,the levels at 24 and 72 hours after surgery in control group were statistically significantly higher than those in observation group（ P〈0.05）. Conclusion Compared with CEA,CSEA can not only restrain the secretion of perioperative plasma cortisol,but also control the rise of plasma D-D after cesarean section,which can be more conducive to improving postoperative blood hypercoagulable state.

关 键 词：连续硬膜外麻醉 腰硬联合麻醉 皮质醇 D-二聚体 

分 类 号：R719.8[医药卫生—妇产科学]