硬膜外麻醉穿破硬脊膜对产妇长期的影响  

Epidural puncture the dura- term impact on maternal

作　　者：吕玲 郭继梅 宫玉环 LV Ling;GUO Ji - mei;GONG Yu - huan(Department of gynaecology and obstetrics, The Ninth People's Hospital of Qingdao, Qingdao 266(^)2, China)

机构地区：[1]山东省青岛市第九人民医院妇产科,山东青岛266002

出　　处：《吉林医学》2016年第7期1611-1613,共3页Jilin Medical Journal

摘　　要：目的:通过研究孕妇硬膜外麻醉后因穿破硬脊膜而引发的头痛、背痛等长期并发症让孕妇了解该麻醉的并发症并且来帮助孕妇决定是否应用硬膜外麻醉来做无痛分娩。方法:选取硬膜外麻醉后穿透硬脊膜产妇308人作为研究组。同期硬膜外麻醉后无穿透硬脊膜产妇50人作为对照组,研究硬膜外麻醉后症状(持续6周)包括头痛,背痛,颈痛,听力,视力。结果:研究组与对照组比较,急性期所有的症状都有显著性差异,(75.9%,19.6%,P<0.01),其中头痛(75.9%,8.7%,P<0.01),背痛(47.2%对19.6%,P=0.02)颈痛(30.1%对2.2%,P<0.01),听力(13.8%对0%,P=0.02),视力症状(19.5%对0%,P=0.02),两组比较长期并发症也有显著意义(58.1%对4.4%,P=0.04),其中慢性头痛(34.9%对2.2%,P<0.01),背痛(58.1%对4.4%,P<0.01),颈痛(14%对0%,P=0.02),听力和视力症状两组比较,差异无统计学意义(P>0.05)。结论:慢性头痛和背痛是产妇硬膜外麻醉后穿透硬脊膜后常见的并发症,当孕妇要求无痛分娩时,应告知孕妇麻醉后的长期并发症,让其决定是否应用该麻醉。Objective We sought to elucidate the long - term ( N 6 weeks) sequelae of PDPH by examining parturients whohad UDP ( both recognized and unrecognized) associated with labor epidural analgesia we evaluated the long - term complications of UDP, which was important in assisting parturients in the decision - making informed consent process. Method Parturients witha documented UDP (n = 308) act as study, a control group (no documented UDP, n=5Q) in the same period. Specific symptomsincluded headache, backache, neck ache, auditory symptoms, and visual symptoms. Results In comparing parturients with a UDPwith control group (no UDP) , differences were noted in overall acute symptoms (75. 9% vs 19. 6 % ,P <0. 0 1 ), specifically headache(75. 9% ,8. 7% < 0. 01) , backache (47. 2% vs 19. 6% ,P = 0. 02) , neck ache ( 30. 1% vs 2. 2% , P < 0. 01 ) , auditory(13. 8% vs 0% = 0. 02) , and visual symptoms (19. 5% vs 0% = 0. 02). Differences were also noted in comparing chronicsymptoms(58. 1% vs 4. 4% ,P =0. 04) and specifically with respect to chronic headache (34. 9% vs 2. 2% ,P <0. 01) , backache(58. 1% vs 4. 4% ,P <0. 01) , and neck ache ( 14. 0% vs 0% =0. 02). No differences were noted between groups in comparingchronic auditory and visual symptoms (P >0. 05). Conclusion Chronic headache and backache sequelae persist in the obstetricalpopulation after UDP. When parturients are considering labor epidural analgesia, long - term sequelae should be discussed in theinformed consent decision - making process.

关 键 词：硬膜外麻醉 硬脊膜穿破 长期并发症 

分 类 号：R614[医药卫生—麻醉学]