腰硬联合麻醉复合硬膜外镇痛对高血压产妇血压水平及镇痛效果的影响  

Effect of Combined Spinal-epidural Anesthesia Combined with Epidural Analgesia on Blood Pressure Level and Analgesia Effect of Hypertensive Parturients

作　　者：郜书杰 张新鹏 左威 GAO Shujie;ZHANG Xinpeng;ZUO Wei(Department of Anesthesiology,Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州市中医院麻醉科,河南郑州450000

出　　处：《中外医疗》2025年第2期10-13,共4页China & Foreign Medical Treatment

摘　　要：目的 分析腰硬联合麻醉复合硬膜外镇痛对高血压患者在分娩过程中的血压水平和止痛效果的影响。方法 随机选取2023年1—12月郑州市中医院收治的50例高血压产妇为研究对象,以不同麻醉方法分为两组,各25例。对照组实施硬膜外麻醉,观察组实施腰硬联合麻醉复合硬膜外麻醉,比较两组患者不同时间段的收缩压、舒张压、视觉模拟评分法(Visual Analogue Scale,VAS)评分、产程时间。结果 镇痛后5 min、镇痛后10 min、活跃期和第二产程时,观察组的收缩压和舒张压水平均低于对照组,差异均有统计学意义(P均<0.05)。观察组第一产程、第二产程、第三产程VAS评分均低于对照组,差异均有统计学意义(P均<0.05)。观察组第一产程、第二产程、第三产程时间分别为(564.68±22.25)min、(93.40±2.65)min、(9.12±0.25)min,均短于对照组的(632.16±31.14)min、(96.51±2.44)min、(12.44±1.68)min,差异均有统计学意义(t=8.816,4.317,9.773;P均<0.05)。结论 高血压产妇可采用联合腰硬麻醉和复合硬膜外镇痛,不仅可以更好地控制血压,还能有效镇痛,缩短产程。Objective To analyze the effect of combined spinal-epidural anesthesia combined with epidural analgesia on blood pressure level and analgesic effect of hypertensive patients during delivery.Methods From January to December 2023,50 hypertensive parturients admitted to Zhengzhou Traditional Chinese Medicine Hospital were randomly selected as the research objects.They were divided into two groups according to different anesthesia methods,with 25 cases in each group.The control group was given epidural anesthesia,and the observation group was given combined spinal-epidural anesthesia combined with epidural anesthesia.The systolic blood pressure,diastolic blood pressure,Visual Analogue Scale(VAS)score and duration of labor were compared between the two groups at different time periods.Results The levels of systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group at 5 min after analgesia,10 min after analgesia,active phase and the second stage of labor,and the differences were statistically significant(all P<0.05).The VAS scores of the first,second and third stages of labor in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The first stage of labor,the second stage of labor and the third stage of labor in the observation group were(564.68±22.25)min,(93.40±2.65)min and(9.12±0.25)min,respectively,which were shorter than(632.16±31.14)min,(96.51±2.44)min and(12.44±1.68)min in the control group,and the differences were statistically significant(t=8.816,4.317,9.773;all P<0.05).Conclusion Combined spinal epidural anesthesia and combined epidural analgesia can be used in hypertensive parturients,which can not only better control blood pressure,but also effectively relieve pain and shorten the labor process.

关 键 词：腰硬联合麻醉 硬膜外镇痛 高血压 产妇 血压水平 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]