产房中紧急实施全身麻醉产科手术临床效果和安全性分析  

Analysis of clinical effect and safety of emergency general anesthesia obstetric operation in delivery room

作　　者：郑光军[1] 廖小杰[1] 袁宝换 李晓霞[1] 黄丽华[1] 涂远艳[1] 郭桂芳[1] 

机构地区：[1]广东省东莞市妇幼保健院麻醉科,广东东莞523000

出　　处：《中国医药科学》2017年第8期106-108,共3页China Medicine And Pharmacy

基　　金：广东省东莞市医疗卫生科技计划项目(20131051010177)

摘　　要：目的探讨产房中紧急实施全身麻醉产科手术临床效果及安全性。方法收集2015年2月~2016年12月我院产房试产失败紧急全身麻醉剖宫产患者45例临床资料行回顾性分析,根据患者麻醉地方分为A组(产房中紧急全身麻醉行剖宫产,21例)和B组(手术室紧急全身麻醉行剖宫产,24例),比较两组患者紧急麻醉时间、术中出血量、紧急分娩时间,麻醉前、插管后5min、手术开始、术毕时两组患者平均动脉压(MAP)及新生儿窒息、新生儿死亡、产妇术后躁动、产妇麻醉误吸发生率。结果 A组患者紧急麻醉时间、紧急手术时间均短于B组[(3.5±1.0)min vs.(8.7±1.5)min,(15.4±2.9)min vs.(20.4±3.8)min,P<0.05]。两组患者麻醉前、插管后5min、手术开始、术毕时MAP水平比较无统计学意义(P>0.05)。A组新生儿窒息发生率低于B组(47.62%vs.83.33%,P<0.05);新生儿死亡、产妇术后躁动及麻醉误吸比较无统计学意义(P>0.05)。结论产房中紧急实施全身麻醉产科手术可争取麻醉和手术时间,改善产妇及新生儿预后,并不增加麻醉风险。Objective To discuss the clinical effect and safety of emergency general anesthesia obstetric operation in delivery room. Methods Clinical data of 45 cases with failed trial of labor and for emergency general anesthesia obstetric operation from February 2015 to December 2017 in hospital were retrospectively analyzed, and all caseds were divided into group A（emergency delivery in the delivery room cesarean section, 21 cases） and group B（operating room emergency general anesthesia cesarean section, 24 cases） according to the place of anesthesia. Emergency anesthesia time, intraoperative blood loss, emergency delivery time, mean arterial pressure（MAP） before anesthesia, after intubation 5min, start of operation, the end of surgery and neonatal asphyxia, neonatal death, postoperative agitation, the incidence of maternal anesthesia of two groups were compared. Results Emergency anesthesia time and emergency delivery time of group A were shorter than those of group[（3.5 ± 1.0）min vs.（8.7 ± 1.5）min,（15.4 ± 2.9）min vs.（20.4 ±3.8）min, P 〈 0.05]. MAP of two groups at before anesthesia, after intubation 5min, start of operation, the end of surgery showed no significant difference（P 〉 0.05）. Incidence of neonatal asphyxia of group A was lower than that of group B（47.62% vs.83.33%, P 〈 0.05）. Neonatal mortality, postoperative agitation and the rate of anesthesia of two groups showed no significant difference（P 〉 0.05）. Conclusion Emergency general anesthesia obstetric operation in delivery room shorten anesthesia and surgery time, improve maternal and neonatal prognosis, and does not increase the risk of anesthesia.

关 键 词：产房 紧急全身麻醉 麻醉效果 安全性 手术 

分 类 号：R614.2[医药卫生—麻醉学]