比较剖宫产术中采用硬膜外麻醉和腰硬联合麻醉的效果及对母婴的影响  

Comparation of Effect of Epidural Anesthesia and Combined Spinal-Epidural Anesthesia in Cesarean Section and their Influence on Mother and Infant

作　　者：杨璇 YANG Xuan(Department of Anesthesiology,Heishan County Maternal and Child Health Hospital,Jinzhou 121400,China)

机构地区：[1]辽宁省锦州市黑山县妇幼保健院麻醉科,辽宁锦州121400

出　　处：《中国医药指南》2021年第35期22-24,共3页Guide of China Medicine

摘　　要：目的比较剖宫产术中采用硬膜外麻醉和腰硬联合麻醉的效果及对母婴的影响。方法随机选取我院2018年10月至2019年10月收治的接受剖宫产术产妇共102例,作为研究对象,对这些产妇实施随机分为研究组和对比组的分组处理,研究组产妇有51例,对比组产妇有51例,研究组产妇在剖宫产手术过程中,主要使用腰硬联合麻醉的方式对产妇麻醉处理,而对比组产妇在手术治疗的时候,主要使用硬膜外麻醉的麻醉方式加以处理,对两组产妇的生命体征、应激激素水平、镇痛效果、镇静效果、恶心呕吐评分、麻醉指标以及其麻醉处理的效果等加以观察和对比分析。结果T_(0)、T_(1)时两组患者的心率、平均动脉压之间的差异均不显著(P>0.05),T_(2)、T_(3)、T_(4)时研究组产妇的心率、平均动脉压均显著低于对比组(P<0.05)。T_(0)时两组产妇的COR、NE、TDR、TCTH水平之间的差异均不显著(P>0.05),T_(1)、T_(2)、T_(3)时研究组产妇的COR、NE、TDR、TCTH水平均显著低于对比组(P<0.05)。术后1 h、3 h、6 h、12 h、24 h,研究组产妇的VAS评分均低于对比组(P<0.05),但两组产妇的Ramsay评分、PONV评分之间的差异均不显著(P>0.05)。研究组产妇的麻醉起效时间和阻滞时间等明显由于对比组,两组差异显著(P<0.05)。研究组产妇的麻醉效果有效率主要显示为97.91%,对比组产妇的麻醉效果有效率为83.31%,研究组产妇的麻醉效果和对比组产妇的麻醉效果对比差异较为明显,有统计学意义(P<0.05)。研究组产妇的感觉阻滞评分和产妇的Bromage评分等都明显要比对比组产妇高,两组对比差异较为显著,有统计学意义(P<0.05)。研究组母婴出现的不良反应发生率明显要比对比组母婴少,两组对比具有统计学意义(P<0.05)。结论腰硬联合麻醉的麻醉方式在剖宫产术后中加以应用的时候,其麻醉的效果起效相对较快,其镇痛效果也比较显著,这一麻醉�Objective To compare the effects of epidural anesthesia and combined spinal-epidural anesthesia in cesarean section and their effects on mothers and infants.Methods One hundred and two cases of parturients receiving cesarean section in our hospital from October 2018 to October 2019 were randomly selected.As the research object,these parturients were randomly divided into study group and control group.There were 51 parturients in study group and 51 parturients in control group.The study group mainly used combined spinal-epidural anesthesia to anaesthetize parturients during cesarean section.In the control group,epidural anesthesia was mainly used to treat the puerpera during the operation.The vital signs,stress hormone levels,analgesic effects,sedative effects,nausea and vomiting scores,anesthesia indexes and the effect of anesthesia between the two groups were observed and compared.Results There was no significant difference in heart rate and mean arterial pressure between the two groups at T_(0) and T_(1)(P>0.05).The heart rate and mean arterial pressure of the study group were significantly lower than those of the control group at T_(2),T_(3)and T_(4)(P<0.05).There was no significant difference in the levels of COR,NE,TDR and TCTH between the two groups at T_(0)(P>0.05).The levels of COR,NE,TDR and TCTH in the study group were significantly lower than those in the control group at T_(1),T_(2)and T_(3)(P<0.05).At 1 hours,3 hours,6 hours,12 hours and 24 hours after operation,the VAS score of the study group was lower than that of the control group(P<0.05),but there was no significant difference in Ramsay score and PONV score between the two groups(P>0.05).The onset time and block time of anesthesia in the study group were significantly different from those in the control group(P<0.05).The effective rate of anesthesia effect of the study group was 97.91%,and that of the control group was 83.31%.The difference between the anesthesia effect of the study group and that of the control group was significant(P<0.05).The

关 键 词：剖宫产术 硬膜外麻醉 腰硬联合麻醉 母婴 影响 

分 类 号：R719.8[医药卫生—妇产科学] R614[医药卫生—临床医学]