腰硬联合麻醉与连续硬膜外麻醉在瘢痕子宫剖宫产手术中的应用比较  

Comparison of combined spinal-epidural anesthesia and continuous epidural anesthesia in cesarean section of the puerperas with scar uterus

作　　者：顾振华[1] 陈志峰[2] GU Zhen-hua;CHEN Zhi-feng(Department of Anesthesiology,Maternity Hospital of Pudong New Area,Shanghai 201200,China)

机构地区：[1]上海市浦东新区妇幼保健院,上海201200 [2]上海交通大学医学院附属第九人民医院,上海200011

出　　处：《医药论坛杂志》2019年第11期55-58,共4页Journal of Medical Forum

摘　　要：目的观察比较腰硬联合麻醉(CSEA)与连续硬膜外麻醉(CEA)在瘢痕子宫剖宫产手术中的应用效果。方法选择上海浦东新区妇幼保健医院在2015年3月至2018年3月收诊的瘢痕子宫产妇择期行剖宫产手术病人300例,随机分为CSEA组和CEA组各150例,CSEA组150例给予腰硬联合麻醉,CEA组150例患者给予连续硬膜外麻醉,比较2组的手术、麻醉效果及对产妇、新生儿的影响。结果CSEA组产妇麻醉起效时间、手术时间以及新生儿娩出时间均明显短于CEA组产妇,组间差异比较有统计学意义(P<0.05);CSEA组产妇良好镇痛率、良好肌松率和无牵拉反应率分别为96.00%、84.67%和90.00%,CEA组产妇良好镇痛率、良好肌松率和无牵拉反应率分别为66.00%、58.67%和60.00%,组间差异比较有统计学意义(P<0.05)。结论CSEA应用于瘢痕子宫剖宫产手术效果满意,麻醉起效快,镇痛及肌松效果良好,可显著缩短新生儿娩出时间和手术时间,安全可靠,值得临床推广。Objective To compare the effects of combined spinal-epidural anesthesia(CSEA)with continuous epidural anesthesia(CEA)in application of cesarean section of the puerperas with scar uterus.Methods Totally 300 women with scarred uterus who underwent elective cesarean section from March 2015 to March 2018 in Shanghai Pudong New Area Maternal and Child Health Hospital were randomly divided into CSEA group and CEA group,150 cases in CSEA group were given combined spinal-epidural anesthesia,150 cases in CEA group were given continuous epidural anesthesia,and the effects of operation,anesthesia and neonates in the two groups were compared.Results The time of onset of anaesthesia,operation time and time of neonatal delivery in CSEA group were significantly shorter than those in CEA group.The difference between the two groups was statistically significant(P<0.05).The good analgesia rate,good muscle relaxation rate and good rate of maternal in CSEA group.The non-drawing reaction rates were 96.00%,84.67%,and 90.00%,respectively.The good analgesia rate,good muscle relaxation rate,and no-drawing reaction rate in the CEA group were 66.00%,58.67%,and 60.00%,respectively.Statistical significance(P<0.05).Conclusion CSEA is used in scar uterine cesarean section with satisfactory results,rapid onset of anesthesia,good analgesia and muscle relaxation,which can significantly shorten the delivery time and operation time of newborns.It is safe and reliable and worthy of clinical promotion.

关 键 词：腰硬联合麻醉 硬膜外麻醉 剖宫产 瘢痕子宫 

分 类 号：B614[哲学宗教—外国哲学]