28例完全性前置胎盘大出血麻醉体会  

Experience of 28 Cases of Complete Placenta Previa Hemorrhage

作　　者：覃兴龙 陈佳婷 黄春柳 卢运萍 QIN Xinglong;CHEN Jiating;HUANG Chunliu;LU Yunping(Department of Anesthesiology,Dongguan Binhaiwan Central Hospital,Dongguan Guangdong 523900,China)

机构地区：[1]东莞市滨海湾中心医院麻醉科,广东东莞523900

出　　处：《中国继续医学教育》2021年第9期139-142,共4页China Continuing Medical Education

摘　　要：目的探讨完全性前置胎盘的麻醉及要点。方法回顾分析2018年1月—2019年11月于医院行剖宫产手术麻醉的完全性前置胎盘大出血产妇的临床资料28例,观察记录产妇术中出血量、输血情况、自体血回收量及洗涤后回输血量,产妇子宫最后处理情况,产妇术后疼痛情况及术后入ICU例数。观察记录新生儿1、5 min Apgar评分和体质量情况。结果28例产妇术后镇痛效果均良好;所有产妇均顺利康复出院。28例新生儿出生情况均良好,1、5 min Apgar评分均在9分以上。结论完全性前置胎盘产妇行剖宫产手术终止妊娠,术中大出血对手术与麻醉风险极大。麻醉医师术前访视应认真查看相关检查资料,做好术前评估,制定合适的麻醉方案,作好充分的术前准备。Objective To investigate the anesthesia and main points of complete placenta previa.Methods A retrospective analysis of 28 cases of women with complete placenta previa hemorrhage who underwent cesarean section anesthesia from January 2018 to November 2019 was performed.The amount of blood transfusion after washing,the final treatment of the uterus,the postoperative pain and the number of ICU cases.Apgar score and body weight of newborns were observed and recorded at 1 and 5 minutes.Results The postoperative analgesic effect was good in all 28 women;all the women recovered and were discharged smoothly.Twenty-eight newborns were born in good condition,with Apgar scores above 9 at 1 and 5 minutes.Conclusion Cesarean section is performed to terminate the pregnancy in women with complete placenta previa.The major bleeding during operation is a great risk to surgery and anesthesia.The preoperative visit of the anesthesiologist should carefully review the relevant examination data,make a good preoperative evaluation,formulate an appropriate anesthesia plan,and make adequate preoperative preparations.

关 键 词：完全性前置胎盘 胎盘植入 大出血 全身麻醉 血液保护 自体血回收 

分 类 号：R714[医药卫生—妇产科学]