摘要
目的探讨椎管内阻滞麻醉致产妇神经受损的因素,为临床防治措施的制定提供理论依据。方法回顾性分析自2015年1月—2017年1月期间在该院接受椎管内阻滞麻醉剖宫产手术的284例产妇的临床资料,其中发生神经损伤的21例产妇分为A组,未发生神经损伤的263例产妇分为B组。分析椎管内阻滞致神经损伤的原因、临床表现、处理方法及恢复情况。对比两组产妇的临床资料,并通过Logistic回归分析椎管内阻滞麻醉产妇神经受损的相关因素。结果该研究椎管内阻滞致产妇神经损伤的发生率为7.39%,经过对症处理后,20例完全恢复,1例出院后仍存在膀胱充盈感觉丧失。A组产妇有异感的比例为23.81%,无水肿的比例为85.71%,均显著高于B组(P<0.05);两组产妇双胎妊娠的比例、高龄产妇的比例对比,均差异无统计学意义(P>0.05)。Logistic回归分析结果显示,异感是椎管内阻滞麻醉致产妇神经受损的危险因素,而轻度水肿是椎管内阻滞麻醉致产妇神经受损的保护因素(P<0.05)。结论异感为椎管内阻滞麻醉致产妇神经受损的危险因素,而轻度水肿是保护因素,临床应重视神经受损的防治,早期干预,以降低神经受损的发生率,改善患者的预后。
Objective To investigate the factors of maternal nerve damage caused by spinal anesthesia and provide theoretical basis for the development of clinical control measures. Methods The clinical data of 284 women who underwent cesarean section for spinal anesthesia in the hospital from January 2015 to January 2017 were retrospectively analyzed. 21 women with neurological injury were divided into group A. 263 women who did not have nerve damage were divided into group B. To analyze the causes, clinical manifestations, treatment methods and recovery of nerve injury caused by spinal canal block. The clinical data of the two groups of women were compared, and the related factors of neurological damage in the anesthesia of the spinal canal were analyzed by Logistic regression. Results The incidence of maternal nerve injury caused by intraspinal block was 7.39%. After symptomatic treatment, 20 cases recovered completely, and 1 case still had loss of bladder filling feeling after discharge. The proportion of senile sensation in group A was 23.81%, and the proportion of edema was 85.71%, which was significantly higher than that in group B （P〈0.05）. The proportion of maternal twin pregnancy and the ratio of maternal age were different. Not statistically significant （P〉0.05）. Logistic regression analysis showed that the heterosexuality was a risk factor for maternal nerve damage caused by spinal anesthesia, and mild edema was a protective factor for maternal nerve damage caused by spinal anesthesia （P〈0.05）. Conclusion Muscle is a risk factor for maternal nerve damage caused by spinal anesthesia, and mild edema is a protective factor. Clinical attention should be paid to the prevention and treatment of nerve damage, early intervention to reduce the incidence of nerve damage and improve patients＇ prognosis.
作者
古兵虹
李九红
张月凌
马长龙
GU Bing-hong;LI Jiu-hong;ZHANG Yue-ling;MA Chang-long(Department of Anesthesiology,Shangdi Hospital,Beijing,100084 China)
出处
《中外医疗》
2018年第27期1-3,6,共4页
China & Foreign Medical Treatment
关键词
椎管内阻滞麻醉
产妇
神经受损
因素
Spinal canal block anesthesia
Maternal
Nerve damage
Factors
