靶控静脉全身麻醉在急诊剖宫产中的应用  

Application of Target Controlled Intravenous General Anesthesia in Emergency Cesarean Section

作　　者：徐萍 汪林花 彭七华 XU Ping;WANG Linhua;PENG Qihua(Department of Anesthesiology,Shenzhen Far East Maternity Hospital,Shenzhen,Guangdong Province,518000 China;Department of Operating Room,Futian District Maternal and Child Health Hospital,Shenzhen,Guangdong Province,518000 China;Department of Anesthesiology,Union Shenzhen Hospital of Huazhong University of Science and Technology,Shenzhen,Guangdong Province,518000 China)

机构地区：[1]深圳远东妇产医院麻醉科,广东深圳518000 [2]深圳市福田区妇幼保健院手术室,广东深圳518000 [3]华中科技大学协和深圳医院麻醉科,广东深圳518000

出　　处：《中外医疗》2023年第4期119-122,共4页China & Foreign Medical Treatment

基　　金：深圳市罗湖区科技创新局科研立项(LX20191301)。

摘　　要：目的探究靶控静脉全身麻醉用于急诊剖宫产对产妇及胎儿的影响及应用效果评价。方法选取2019年4月—2020年6月深圳远东妇产医院收治的80例行急诊剖宫产产妇为研究对象,按照麻醉方式分为两组。其中,40例在靶控静脉全身麻醉下行剖宫产术,纳为观察组;40例在单纯腰麻下行急诊剖宫产术,纳为对照组。观察比较两组手术时间、术中出血量,新生儿1 min、5 min Apgar评分,动脉压和心率变化等。结果治疗后,两组手术时间、术中出血量、Apgar评分比较,差异无统计学意义(P>0.05)。治疗后,观察组T1平均动脉压、心率分别为(77.99±21.01)mmHg、(70.05±30.10)次/min,T2平均动脉压、心率分别为(82.91±15.14)mmHg、(70.08±21.36)次/min,T3平均动脉压、心率分别为(92.51±23.25)mmHg、(87.98±10.16)次/min,与对照组相比,差异有统计学意义(t=2.085、2.592、1.996、2.072、3.861、2.612,P<0.05)。观察组从切皮到胎儿取出时间为2 min的有22例、为3 min的有8例、为4 min的有5例、为≥5 min的有5例,对照组2 min的有11例、3 min的有14例、4 min的有9例、≥5 min的有6例,差异有统计学意义(χ^(2)=6.537,P<0.05)。结论与单纯腰麻相比,急诊剖宫产产妇实施靶控静脉全身麻醉的手术时间、术中出血量相当,新生儿仅在娩出后1 min内出现轻微的呼吸抑制,且可自行恢复,但可明显改善产妇术中的血压和心率指标,安全性较高。Objective To explore the effect of target controlled intravenous general anesthesia on puerpera and fetus during emergency cesarean section.Methods From April 2019 to June 2020,80 cases of emergency cesarean section women admitted to Shenzhen Far East Obstetrics and Gynecology Hospital were selected as the study subjects and divided into two groups according to the anesthesia anesthesia method.Among them,40 cases of cesarean section under target controlled intravenous general anesthesia were included in the observation group;40 cases of emergency cesarean section under simple spinal anesthesia were included in the control group.The operation time,intraoperative bleeding,Apgar scores,arterial pressure,and heart rate changes of the newborns at 1 and 5 minutes were observed and compared between the two groups.Results After treatment,there was no statistically significant difference in surgical time,intraoperative bleeding,and Apgar score between the two groups(P>0.05).After treatment,the T1 mean arterial pressure and heart rate in the observation group were(77.99±21.01)mmHg and(70.05±30.10)beats/min,respectively;the mean arterial pressure and heart rate on T2 were(82.91±15.14)mmHg and(70.08±21.36)beats/min,respectively;the mean arterial pressure and heart rate in T3 group were(92.51±23.25)mmHg and(87.98±10.16)beats/min,respectively,which were compared with the control group,and the difference was statistically significant(t=2.085,2.592,1.996,2.072,3.861,2.612,P<0.05),in the observation group,there were 22 cases with a time from skin incision to fetal extraction of 2 min,8 cases with a time of 3 min,5 cases with a time of 4 min,and 5 cases with a time of≥5 min.In the control group,there were 11 cases with a time of 2 min,14 cases with a time of 3 min,9 cases with a time of 4 min,and 6 cases with a time of≥5 min,and the difference was statistically significant(χ^(2)=6.537,P<0.05).Conclusion Compared with simple spinal anesthesia,target controlled intravenous general anesthesia for emergency cesarean section

关 键 词：急诊剖宫产 病理产科 靶控静脉全身麻醉 APGAR评分 

分 类 号：R725[医药卫生—儿科]