摘要
目的:了解剖富产手术中单纯硬膜外麻醉(EA)、腰麻-硬膜外联合麻醉(CSEA)和静脉麻醉(IA)的临床效果。方法:急诊剖宫产手术180例,随机分为三组,A组为单纯硬膜外麻醉,B组为腰麻-硬膜外联合麻醉,C组为静脉麻醉。术中观察平均动脉压、心率、血氧饱和度,记录麻醉效果和起效时间、Bromage评分、术中、术后不良反应以及新生儿Apgar评分。结果:三组产妇在平均动脉压、心率、血氧饱和度、新生儿Apgr评分和不良反应差异无统计学意义(p>0.05),麻醉效果满意率、麻醉起效时间和Bromage评分差异有统计学意义(P<0.05)。结论:EA用于刨宫产手术存在麻醉诱导时间长、骶神经阻滞不完善、特别是膀胱腹膜反折处疼痛以及肌松欠佳等缺点,新生儿Apgar评分与其它两组相比略有偏低,但无统计学意义(P>0.05);IA用于剖宫产对新生儿安全无明显影响;选用CSEA较佳操作方便,麻醉平面易控制,成功率高,且费用少,可视为剖宫产术的首选麻醉方法。
Objective：Simple to understand caesarean section with epidural anesthesia （EA）,spinal anesthesia-epidural anesthesia （CSEA） and intravenous anesthesia （IA） of the clinical effects.Methods： 180 cases of emergency cesarean section were randomly divided into 3 groups,A group for pure epidural anesthesia,B group,spinal anesthesia-epidural anesthesia,C group intravenous anesthesia.Intraoperative mean arterial pressure,heart rate,oxygen saturation,recorded the onset time of narcotic effect and,Bromage score,intraoperative and postoperative adverse events and neonatal Apgar score.Results：Three groups were in mean arterial blood pressure,heart rate,oxygen saturation,neonatal Apgar scores and adverse reactions was no significant difference （P〉0.05）,anesthesia satisfaction rate,anesthesia onset time and the Bromage score difference between the statistics significance （P 〈0.05）Conclusion：EA induction of anesthesia for cesarean section there is a long time,sacral nerve block imperfect,especially in the bladder peritoneal fold at pain,poor muscle relaxation,as well as the shortcomings of a long induction time;neonatal Apgar score,compared with the other two groups slightly low, but no statistical significance （P〉0.05）,IA for the safety of cesarean section had no significant effect on the newborn;use CSEA better,convenient operation,anesthesia plane easy to control,a high success rate,and the cost less,can be regarded as the preferred cesarean section anesthesia.
出处
《中国医药导刊》
2010年第7期1120-1121,共2页
Chinese Journal of Medicinal Guide
关键词
硬膜外麻醉
腰麻-硬膜外联合麻醉
静脉麻醉
Epidural anesthesia
Spinal anesthesia-epidural anesthesia
Intravenous anesthesia
