妊高症产妇剖宫产术腰麻后低血压及母婴结局的回顾性研究  

Retrospective analysis on hypotension and maternal and neonatal outcomes in pregnant women with hypertension after cesarean section under spinal anesthesia

作　　者：郭蕾 秦蕊[1] 史永强 陈易[1] 黄丽娟[2] 步如飞 陈进华[1] GUO Lei;QIN Rui;SHI Yongqiang;CHEN Yi;HUANG Lijuan;BU Rufei;CHEN Jinhua(Department of Anesthesiology and Perioperative Medical,General Hospital of Ningxia Medical University,Yichuan 750004,China;Department of Obstetrics,General Hospital of Ningxia Medical University,Yichuan 750004,China;Department of Neonatology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院麻醉与围手术期医学科,宁夏银川750004 [2]宁夏医科大学总医院产科,宁夏银川750004 [3]宁夏医科大学总医院新生儿科,宁夏银川750004

出　　处：《宁夏医学杂志》2023年第12期1091-1093,共3页Ningxia Medical Journal

基　　金：宁夏卫生健康系统科研课题(2022NWKY056)。

摘　　要：目的回顾性分析妊高症产妇剖宫产术腰麻后低血压发生率及母婴结局。方法回顾性分析年龄≥18岁单胎在腰麻下行剖宫产术的妊高症产妇353例。根据妊娠期高血压不同特征分为妊娠期高血压组(113例)、轻度子痫前期组(91例)及重度子痫前期组(149例)。分别记录产妇一般资料及腰麻后低血压、腰麻后严重低血压、心动过缓发生率、新生儿1 min及5 min Apgar评分、新生儿转科率。结果重度及轻度子痫前期组产妇较妊娠期高血压组产妇孕周更小(P<0.05)、基础收缩压更高(P<0.05)、腰麻后低血压发生率更低(P<0.05)、新生儿1 min和5 min Apgar评分较低(P<0.05),新生儿转科率较高(P<0.05)。结论轻度及重度子痫前期产妇较妊娠期高血压产妇腰麻后低血压发生率更低,但新生儿Apgar评分更低、转科率更高。Objective To analyze the incidence of post-spinal anesthesia hypotension and maternal and neonatal outcomes in patients with pregnancy-induced hypertension syndrome undergoing cesarean section.Methods A retrospective analysis was conducted on 353 pregnant women with pregnancy-induced hypertension syndrome who underwent cesarean section under spinal anesthesia with a single fetus aged≥18 years old.The patients were divided into gestational hypertension group(n=113),mild preeclampsia group(n=91)and severe preeclampsia group(n=149).Maternal and neonatal outcomes including the incidence of post-spinal anesthesia hypotension(SBP<80%of baseline),severe post-spinal anesthesia hypotension(SBP<60%of baseline),bradycardia(HR<60 beats/min),Apgar scores at 1 and 5 min after delivery and the proportion of transfer to pediatrics unit were recorded.Results The gestational weeks were smaller(P<0.05),baseline systolic blood pressure were higher(P<0.05),the incidence of post-spinal anesthesia hypotension decreased(P<0.05),Apgar scores at 1 and 5 min were lower(P<0.05),and the proportion of transfer to pediatrics unit were higer(P<0.05)in the mild preeclampsia group and severe preeclampsia group compared with the gestational hypertension group.Conclusion The incidence of hypotension after spinal anesthesia in mild and severe preeclampsia pregnant women is lower than that in hypertensive pregnant women,but the Apgar score of newborns is lower and the transfer rate of newborns is higher.

关 键 词：妊高症 剖宫产术 腰麻后低血压 母婴结局 回顾性研究 

分 类 号：R714.246[医药卫生—妇产科学]