腰硬联合麻醉剖宫产产妇发生低血压的影响因素  

Influencing factors of hypotension in cesarean section parturients undergoing combined spinal-epidural anesthesia

作　　者：孙剑伟 SUN Jianwei(Department of Anesthesiology of Kaifeng Obstetrics and Gynecology Hospital,Kaifeng 475000 Henan,China)

机构地区：[1]开封市妇产医院麻醉科,河南开封475000

出　　处：《中国民康医学》2023年第23期24-27,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析腰硬联合麻醉剖宫产产妇发生低血压的影响因素。方法:回顾性分析2021年4月至2022年11月于该院择期行剖宫产术的95例产妇的临床资料,术中均行腰硬联合麻醉,统计产妇低血压发生情况,采用Logistic回归分析腰硬联合麻醉剖宫产产妇发生低血压的影响因素。结果:95例腰硬联合麻醉剖宫产产妇发生低血压32例,发生率为33.68%,设为发生组,63例未出现低血压,设为未发生组;发生组体质量指数(BMI)≥28 kg/m^(2)、宫高>36 cm、腹围>100 cm、麻醉平面≥T_(8)、出现Bezold-Jarisch反射、多胎妊娠、胎儿体质量≥4000 g占比均高于未发生组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,BMI≥24 kg/m^(2)、宫高>36 cm、麻醉平面≥T_(8)、出现Bezold-Jarisch反射、多胎妊娠等均为影响硬联合麻醉后剖宫产产妇发生低血压的危险因素(OR>1,P<0.05)。结论:BMI≥24 kg/m^(2)、宫高>36 cm、麻醉平面≥T_(8)、出现Bezold-Jarisch反射、多胎妊娠等均为影响硬联合麻醉剖宫产产妇发生低血压的危险因素。Objective:To analyze influencing factors of hypotension in cesarean section parturients undergoing combined spinal-epidural anesthesia.Methods:The clinical data of 95 parturients undergoing elective cesarean section in this hospital from April 2021 to November 2022 were retrospectively analyzed.The incidence of hypotension during cesarean section under combined spinal-epidural anesthesia was statistically analyzed.Logistic regression was used to analyze the influencing factors of hypotension in the cesarean section parturients undergoing combined spinal-epidural anesthesia.Results:Among the 95 cases,hypotension occurred in 32 cases with an incidence rate of 33.68%,and they were set as the occurrence group;hypotension did not occurred in 63 cases,and they were set as the non-occurrence group.The proportions of the parturients with body mass index(BMI)≥28 kg/m^(2),uterine height>36 cm,abdominal circumference>100 cm,anesthetic plane≥T_(8),Bezold-Jarisch reflex,multiple pregnancy,fetal body mass≥4000 g in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that BMI≥24 kg/m^(2),uterine height>36 cm,anesthetic plane≥T_(8),Bezold-Jarisch reflex,and multiple pregnancy were all risk factors for hypotension in the cesarean section parturients undergoing combined spinal-epidural anesthesia(OR>1,P<0.05).Conclusions:BMI≥24 kg/m^(2),uterine height>36 cm,anesthetic plane≥T_(8),Bezold-Jarisch reflex,and multiple pregnancy are the risk factors for hypotension in the cesarean section parturients undergoing combined spinal-epidural anesthesia.

关 键 词：剖宫产 腰硬联合麻醉 低血压 影响因素 BEZOLD-JARISCH反射 多胎妊娠 

分 类 号：R714.4[医药卫生—妇产科学]