腰硬联合麻醉在不同体位剖宫产产妇中实施效果及对新生儿影响  

Effect of Combined Spinal-Epidural Anesthesia for Different Postural Cesarean Section on Neonates

作　　者：郑光军[1] 廖小杰[1] 袁宝换 李晓霞[1] 黄丽霞[1] 

机构地区：[1]东莞市妇幼保健院,广东东莞523000

出　　处：《现代医院》2017年第7期1047-1049,共3页Modern Hospitals

摘　　要：目的探讨腰硬联合麻醉在不同体位剖宫产产妇中实施效果及对新生儿影响。方法选取2015年2月—2016年12月我院行剖宫产产妇138例为研究对象,根据患者腰硬联合麻醉后采取不同体位分为A组(平卧位,40例)、B组(手术床脚端抬高20°,50例)、C组(手术床左侧倾斜20°,48例),比较三组患者麻醉起效时间及麻醉前(T0)、麻醉1 min(T1)、麻醉2 min(T2)、麻醉5 min(T3)、麻醉10 min(T4)平均动脉组(MAP)及新生儿并发症发生率。结果 B组麻醉起效时间显著短于A、C两组,比较有统计学意义(P<0.05)。麻醉前三组患者MAP水平无明显差异,麻醉后三组患者MAP均有下降,B组下降程度显著于A、C两组,A组下降程度显著于C组,比较有统计学意义(P<0.05)。B组胎儿窘迫发生率显著高于A、C两组,胎心异常、新生儿窒息发生率高于C组,比较有统计学意义(P<0.05)。结论剖宫产手术患者腰硬联合麻醉后将手术床左侧倾斜可有效预防麻醉后低血压发生风险,维持患者血液动力学稳定,降低新生儿并发症发生率。Objective To explore the effect of combined spinal - epidural anesthesia in different postures of cesarean section on neonates. Methods 138 case of cesarean section maternal from February in 2015 to December in 2016 were en-rolled in the study. According to the patients combined with spinal epidural anesthesia after taking different positions were di-vided into group A （at supine position, 40 cases） , Group B （bed end raised by 20 °, 50 cases） . Group C （the operating bed tilted to the left side by 20 °. The three groups were compared in view of TO, anesthesia for 1 min （T1） , anesthesia for 2 min （T2） , anesthesia for 5 min （T3 ） , anesthesia for 10 min （T4） mean arteries （MAP） and neonatal incidence of com-plications. Results Anesthesia onset time in group B was significantly shorter than groups A and C , more statistically signif-icant （P 〈 0. 05 ） . There was no significant difference in MAP level between the three groups before anesthesia. MAP de-creased in all three groups after anesthesia, the decrease of group B was more significant than in group A and C. The decrease of group A was significant than in group C with statistical significance （P 〈 0. 05 ） . The incidence of fetal distress in group B was significantly higher than thats in group A and C, and the incidence of neonatal asphyxia was higher than that of group C, which was statistically significant （P 〈 0. 05 ） . Conclusion The tilting the operating table to left side can effectively prevent the risk of hypotension after anesthesia and to maintain hemodynamic stability in patients with reduced incidence of neonatal complications.

关 键 词：腰硬联合麻醉 不同体位 剖宫产 新生儿 

分 类 号：R719.8[医药卫生—妇产科学]