腰麻硬膜外联合麻醉对剖宫产麻醉效果、血流动力及新生儿Apgar评分的影响  

Effects of combined spinal and epidural anesthesia during cesarean section of women on their anesthesia effect,hemodynamics,and neonatal Apgar score

作　　者：何程巧 曹文鹏 HE Chengqiao;CAO Wenpeng(West China Guang'an Hospital,Sichuan University,Guang'an,Sichuan Province,638000)

机构地区：[1]四川大学华西广安医院,638000

出　　处：《中国计划生育学杂志》2022年第11期2494-2498,共5页Chinese Journal of Family Planning

摘　　要：目的:分析腰麻硬膜外联合麻醉(CSEA)对剖宫产麻醉效果及对产妇血流动力、新生儿Apgar评分的影响。方法:选取2019年1月-2020年1月本院收治的符合剖宫产指征单胎妊娠指针孕妇145例,根据麻醉方式不同分为CSEA组74例与硬膜外麻醉(EA)组71例。对比两组麻醉效果、血流动力学指标、新生儿Apgar评分以及不良反应情况。结果:CSEA组麻醉效果为III级占比(93.2%)高于EA组(33.8%)(P<0.05);CSEA组MAP值在麻醉平稳后、手术结束时均高于EA组,HR在胎儿娩出10min、手术结束时均高于EA组(均P<0.05);两组SpO_(2)值在不同麻醉时刻比较均无差异(P>0.05);CSEA组新生儿出生1min时Apgar评分(9.11±0.25分)高于EA组(8.28±0.85分)(P<0.05),两组在5min时比较5min评分(9.61±0.11分、9.59±0.21分)无差异(P>0.05),CSEA组不良反应发生率(10.8%)与EA组(7.0%)无差异(P>0.05)。结论CSEA在一定程度上可维系产妇血流动力学稳定性,对新生儿无明显不良影响Apgar评分无明显影响,且麻醉效果及安全性佳,可考虑作为剖宫产优先考虑的麻醉方式之一。Objective:To analyze the effects of combined spinal epidural anesthesia(CSEA)of women on their anesthesia effect,hemodynamics,and neonatal Apgar score.Methods:A total of 145 pregnant women with singleton pregnancy who met the guidelines of cesarean section were selected and were divided into 74 cases in group A(women with CSEA)and 71 cases in group B(women with EA)according to different anesthesia methods from January 2019 to January 2020.The effect of anesthesia,the hemodynamic indexes values,the neonatal Apgar scores,and the adverse reactions rate of the women were compared between the two groups.Results:The proportion of grade III anesthesia effect(93.2%)of the women in group A was significantly higher than that(33.8%)of the women in group B(P<0.05).The MAP value of the women in group A after stable anesthesia or at the end of operation was significantly higher than that of the women in group B.The HR value of the women in group A at 10min after fetal delivery or at the end of operation was significantly higher than that of the women in group B(all P<0.05).There was no significant difference in the SpO_(2) value of the women at different anesthesia moments between the two groups(P>0.05).The neonatal Apgar score(9.11±0.25 points)at 1min after birth in group A was significantly higher than that(8.28±0.85 points)in group B(P<0.05).There was no significant difference in the neonatal Apgar score(9.61±0.11 points vs.9.59±0.21 points)at 5min after birth between the two groups(P>0.05).There was no significant difference in the incidence of adverse reactions(10.8%vs.7.0%)of the women between the two groups(P>0.05).Conclusion:CSEA can maintain maternal hemodynamic stability to a certain extent,and which has no obvious adverse significant effect on the neonatal Apgar score,with good anesthesia effects and safety.It can be considered as one of the preferred anesthesia methods for cesarean section.

关 键 词：剖宫产 腰麻硬膜外联合麻醉 麻醉效果 血流动力学 新生儿Apgar评分 

分 类 号：R614[医药卫生—麻醉学]