不同麻醉方式对子痫前期剖宫产术中产妇血流动力学影响  

作　　者：蔡栋江 俞米林 赵刚 赵和平 

机构地区：[1]浙江省诸暨市人民医院,311801

出　　处：《浙江临床医学》2021年第1期116-118,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医学会临床科研基金项目-新晨麻醉医学科研专项(2013ZYC-A108)。

摘　　要：目的探讨气管内插管全身麻醉、蛛网膜下腔阻滞麻醉对子痫前期剖宫产术的麻醉效果及对产妇血流动力学和母婴结局的影响。方法选取2016年1月至2019年6月子痫前期产妇86例,随机分为全身麻醉组(A组)和蛛网膜下腔阻滞麻醉组(B组),各43例。比较两组产妇麻醉效果、起效时间、围术期血流动力学变化及母婴结局。结果A组产妇麻醉起效时间短于B组(P<0.05);两组产妇麻醉效果优良率比较,差异无统计学意义(P>0.05)。两组产妇不同时间点SBP、DBP、HR不同程度降低,与T0比较,差异有统计学意义(P<0.05)。在T1、T2、T3、T4时间点,A组SBP、DBP水平明显高于B组(P<0.05);两组产妇HR水平在T2~T5时间点比较,差异有统计学意义(P<0.05);两组产妇SpO2水平在T0~T5各时间点比较,差异无统计学意义(P>0.05)。两组产妇不同时间点MAP不同程度降低,与T0比较,差异有统计学意义(P<0.05);T1、T4、T5时间点血流动力学指标比较,差异有统计学意义(P<0.05);两组产妇SpOz水平在T0~T5各时间点比较,差异无统计学意义(P>0.05)。两组产妇产后出血量和术中低血压发生率比较,差异无统计学意义(P>0.05);与A组比较,B组产妇术后头痛发生率较A组增高,但差异无统计学意义(P>0.05)。两组胎儿娩出后1 min,5 min Apgar评分比较,差异无统计学意义(P>0.05)。结论子痫前期产妇在行剖宫产术时,全身麻醉与蛛网膜下腔阻滞麻醉同样安全、有效,全身麻醉麻醉起效更快,对产妇血流动力学影响更小,且两种麻醉方法对新生儿Apgar评分均无明显不良影响,可有效保证母婴安全。Objective To investigate the anesthetic effect of endotracheal intubation general anesthesia and subarachnoid block anesthesia on cesarean section of preeclampsia patients and the effect on maternal hemodynamics and maternal and infant outcomes.Methods 86 cases of pregnant women with preeclampsia who were hospitalized in the department of obstetrics and gynecology of Zhuji people's Hospital from January 2016 to June 2019 were randomly divided into the general intravenous anesthesia group(group A)and lumbar anesthesia group(group B),with 43 cases each.The two groups of patients used cesarean section to end the pregnancy,respectively using endotracheal intubation general anesthesia and arachnoid block anesthesia.Anesthesia effect,onset time,perioperative hemodynamic changes and maternal and infant outcomes were compared between the two groups.Results The onset time of anesthesia in group A was shorter than that in group B(1=19.212,P<0.05).There was no statistically significant difference between the two groups(P>0.05).Taking TO before anesthesia as the control group,MAP and HR in the two groups were reduced to different degrees at different time points,and the difference was statistically significant(P<0.05).Comparison between the two groups showed that MAP hemodynamic indexes at time points T1,T4 and T5 in the two groups showed statistically significant differences(P<0.05).HR levels of the two groups were compared at T2~T5 time points,and the difference was statistically significant(P<0.05).There was no statistically significant difference in SpC>2 level between the two groups at different time points of T0~T5(P>0.05).There was no significant difference between the two groups in the incidence of postpartum blood loss and intraoperative hypotension(P>0.05).Compared with group A,the incidence of postoperative headache in group B was higher than that in group A,but the difference was not statistically significant(P>0.05).Apgar scores at 1 min and 5 min after delivery showed no significant difference between the two g

关 键 词：子痫前期 蛛网膜下腔阻滞麻醉 全身麻醉 血流动力学 APGAR评分 

分 类 号：R71[医药卫生—妇产科学]