剖宫产手术麻醉前后保持不同卧位对产妇血压、心率及仰卧位低血压综合征发生率的影响  

Influence of different supine position before and after cesarean section anesthesia on maternal blood pressure,heart rate and incidence of supine hypotension syndrome

作　　者：柯丹纯 黄素华[1] 甘艳军 KE Danchun;HUANG Suhua;GAN Yanjun(Operating Room,Shenzhen Baoan Songgang People’s Hospital,Shenzhen 518105)

机构地区：[1]深圳市宝安区松岗人民医院手术室,广东深圳518105

出　　处：《当代医药论丛》2021年第23期190-192,共3页

基　　金：深圳市宝安区医疗卫生项目(20110468)。

摘　　要：目的:探讨对接受剖宫产手术的产妇进行腰硬联合麻醉前后使其保持不同的卧位对其血压、心率及仰卧位低血压综合征(SHS)发生率的影响。方法:随机抽取近年来在深圳市宝安区松岗人民医院进行剖宫产手术的250例产妇作为研究对象。将其平均分为A组与B组。术中对A组产妇进行腰硬联合麻醉前后均使其保持仰卧位,对B组产妇进行腰硬联合麻醉前使其保持仰卧位,麻醉后迅速调节手术床左倾20°-30°卧位,然后比较两组产妇的各项临床指标。结果:麻醉前,两组产妇的收缩压(SBP)、舒张压(DBP)、心率(HR)相比,P>0.05。麻醉后,A组产妇的SBP和DBP均低于麻醉前,HR高于麻醉前,P<0.05。麻醉后,B组产妇的SBP和DBP均高于A组产妇,HR低于A组产妇,P<0.05。B组产妇术中恶心呕吐、头晕、出冷汗、胸闷气短和SHS的发生率均低于A组产妇,P<0.05。两组产妇的新生儿Apgar评分,P>0.05。结论:与对接受剖宫产手术的产妇进行腰硬联合麻醉前后均使其保持仰卧位相比,在麻醉前使其保持仰卧位、麻醉后迅速调节手术床使其保持左倾20°-30°卧位能有效预防其术中发生低血压、心率过速及SHS。Objective:To explore the different decubitus position of puerpera in cesarean section before and after combined lumbar and epidural anesthesia Blood pressure,heart rate,and incidence of supine hypotension syndrome(SHS).Methods:250 cases of puerpera who underwent cesarean section in Songgang People’s Hospital,Bao‘an district,Shenzhen in recent years were randomly selected as the research object.They were equally divided into group A and group B.During the operation,the parturient women in group A were kept in supine position before and after combined lumbar and epidural anesthesia,and the parturient women in group B were kept in supine position before combined lumbar and epidural anesthesia.After anesthesia,the operating table was adjusted quickly to keep the parturient women in A left leaning position of 20°-30°,and then the clinical indicators of the two groups were compared.Results:Before anesthesia,SBP,DBP and HR were compared between the two groups,P>0.05.After anesthesia,SBP and DBP in group A were lower than before anesthesia,while HR was higher than before anesthesia,P<0.05.After anesthesia,SBP and DBP in group B were higher than those in group A,while HR was lower than those in group A,P<0.05.The incidence of nausea and vomiting,dizziness,cold sweat,chest tightness and shortness of breath and SHS in group B were lower than that in group A,P<0.05.Apgar score of neonates in the two groups,P>0.05.Conclusion:Compared with keeping subsupine position before and after combined lumbar and epidural anesthesia,keeping subsupine position before anesthesia and rapidly adjusting the operating table after anesthesia to keep subsupine position 20°-30°can effectively prevent hypotension,tachycardia and SHS during cesarean section.

关 键 词：剖宫产手术 腰硬联合麻醉 卧位 血压 心率 仰卧位低血压综合征 

分 类 号：R714[医药卫生—妇产科学]