体位干预联合麻黄碱预给予提升剖宫产术患者感觉舒适度  

Position intervention combined with administration of ephedrine in advance promotes comfort of women underwent cesarean section

作　　者：侯广会 何绮月[1] 张卉颖[1] HOU Guang-hui(Department of anesthesiology,Nanjing mingji hospital affiliated to Nanjing Medical University,Nanjing,Jiangsu,210019,China)

机构地区：[1]南京医科大学附属南京明基医院麻醉科,江苏南京210019

出　　处：《齐齐哈尔医学院学报》2020年第23期2978-2980,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨如何更好地减少剖宫产术患者术中仰卧位低血压综合征的发生,以提高患者感觉舒适度。方法选择2019年1—10月本院收治的200例腰麻硬膜外联合麻醉下行剖宫产的产妇作为研究对象,随机数表法分为对照组和观察组两组,每组各100例。对照组按常规麻醉手术,当患者出现低血压,收缩压低于90 mmHg时给予干预。观察组则于患者腰麻硬膜外联合麻醉完成后,即时给予麻黄碱12 mg,并采取左侧倾斜卧位20~30°。观察两组患者心率、血压的变化及术中仰卧位低血压的发生率,恶心呕吐发生率。同时在患者入麻醉恢复室行患者感觉舒适程度回顾性问卷测评。结果观察组患者感觉舒适度明显高于对照组。对照组仰卧位低血压发生31例,发生率明显高于观察组(P<0.05)。结论体位干预联合麻黄碱预给予提升剖宫产术患者感觉舒适度,值得临床推广。Objective To explore how to better reduce the incidence of supine hypotension syndrome in patients undergoing cesarean section,so as to improve the patient's sense of comfort.Methods 200 cases of puerperant received caesarean section under combination of epidural anesthesia and lumbar anesthesia those admitted to our hospital from January to October 2019 were enrolled as study subjects.They were divided into control group and observation group according to random number table method,100 cases in each group.Traditional anesthesia method was applied in the control group,in cases of the appearance of hypopiesia that the systolic blood pressure was lower than 90 mmHg,the intervention was carried out.In the observation group,12 mg of ephedrine was administered immediately after combined lumbar anesthesia and epidural anesthesia was completed.And take the left inclined decubitus position of 20~30°.The changes of heart rate and blood pressure,the incidence of hypotension under supine position and the incidence of nausea and vomiting were observed.A retrospective questionnaire was conducted to evaluate the comfort degree of the patients in the anesthesia recovery room.Results The patients in observation group felt more comfortable than those in control group.There were 31 cases of supine hypotension in control group,which was significantly higher than that in observation group,and the difference between the 2 groups was statistically significant.Conclusions Postural intervention combined with ephedrine could improve the comfort level of puerperant received cesarean section patients,which is worthy of clinical promotion.

关 键 词：剖宫产 仰卧位低血压综合征 麻黄碱 左倾卧位 感觉舒适度 

分 类 号：R614[医药卫生—麻醉学]