超声辅助定位可以提高肥胖产妇蛛网膜下腔麻醉穿刺成功率  

Ultrasound-assisted Localization Improves Success Rate of Subarachnoid Anaesthesia Puncture in Obese Pregnants

作　　者：庞超 戴泽平[1] PANG Chao DAI Zeping(Department of Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu 241001, China)

机构地区：[1]皖南医学院弋矶山医院麻醉科,安徽芜湖241001

出　　处：《沈阳医学院学报》2017年第5期392-394,共3页Journal of Shenyang Medical College

摘　　要：目的:探讨超声辅助定位能否提高肥胖产妇蛛网膜下腔麻醉(简称腰麻)穿刺成功率。方法:选取皖南医学院弋矶山医院2016年10月至2017年2月腰麻下行剖宫产的肥胖产妇100例,随机分为观察组和对照组,每组50例。对照组采用手法触摸,选取L3-4间隙进行穿刺,观察组采用超声辅助定位并标记L3-4间隙及穿刺点。记录穿刺次数、改变穿刺方向次数、总操作时间(T1)、定位时间(T2)、腰麻穿刺时间(T3)和术后腰部疼痛发生率。结果:观察组一次穿刺成功率为(67%),显著高于对照组的36%,差异有统计学意义(P<0.05)。与对照组比较,观察组在穿刺次数、改变穿刺方向的次数和术后腰部疼痛发生率上明显降低,差异有统计学意义(P<0.05);观察组在腰麻穿刺时间上明显缩短,差异有统计学意义(P<0.05)。而在腰麻总操作时间上2组比较,差异无统计学意义(P>0.05)。结论:超声辅助定位能显著提高肥胖产妇剖宫产腰麻穿刺的成功率,并且降低腰麻穿刺次数及术后腰部疼痛的发生率。Objective：To investigate whether ultrasound-assisted localization technique can improve success rate of subarachnoid anaesthesia puncture in obese pregnants. Methods： From Oct 2016 to Feb 2017,100 cases of obese pregnants who underwent cesarean section under subarachnoid anaesthesia at Yijishan hospital of Wannan Medical College were selected as subjects and were randomly devided into the ultrasound group and the palpation group, 50 cases in each group. In both groups the level of L3-4 was identified by ultrasound or palpation. The numbers of skin punctures and needle passes,total procedure time（T1）, time taken to establish landmarks （T2）, time taken to perform spinal anesthesia （T3）, and incidence of postoperative lumbar pain were recorded. Results： The success rate of primary puncture in the ultrasound group was significantly higher than that in the palpation group （67% vs 36%,p〈0.05）. Compared with the palpation group,the number of skin punctures, number of needle passes, and incidence of postoperative lumbar pain were significantly lower in the ultrasound group（p〈0.05）. The difference was statistically significant in the time taken to perform spinal anaesthesia between the two groups（p〈0.05）, while the total procedure time was similar in both groups（p〉0.05）. Conclusion： Ultrasound-assisted localization technique significantly improves success rate of subarachnoid anaesthesia in obese pregnants, and reduces the number of punctures and the incidence of postoperative lumbar pain.

关 键 词：剖宫产 肥胖 腰麻 超声 

分 类 号：R614[医药卫生—麻醉学]