摘要
目的：研究腰麻联合硬膜外麻醉在剖宫产手术的应用。方法：选择100例需行剖宫产术的健康临产妇，按照自愿原则分为腰麻联合硬膜外麻醉（CSEA）组52例和硬膜外麻醉（EA）组48例。麻醉过程中监测血压、心率、脉搏、血氧饱和度等，记录手术时间、麻醉起效时间、麻醉至胎儿娩出时间；记录新生儿娩出1分钟和5分钟的Apgar评分；并记录麻醉并发症及是否出现低血压、恶心、呕吐、寒战、头痛等不良反应。结果：两组术中两种麻醉方式麻黄素用量、新生儿Apgar评分、产妇出现的不良反应间比较，差异均无统计学意义（P〉0．05）。腰麻联舍硬膜外麻醉组的麻醉起效时间、手术时间及注射局部麻醉药到胎儿娩出的时间明显少于硬膜外麻醉组，两者比较，差异有统计学意义（P〈0．05）。结论：腰麻联合硬膜外麻醉具有用药剂量小、起效快、阻滞完善、镇痛效果满意、并发症少等优点，现在已被广泛应用于产科剖宫产手术。
Obsjective To research applications of lumbar spinal anesthesia2ep idural anesthesia in e2mergency Cesarean section surgery. MethodsTaking 60 healthy p regnantwomen who are brought to bedand required emergency Cesarean section surgery. Theywere randomly divided into two group s equally for ep idural anesthesia and lumbar spinal anesthesia2ep idural anesthesia. Blood dynamics was monitored in the course of anesthesia. The times of block levels to T8 and injected anesthetic to the fetus delivered were recorded in the anesthesia effort table; newborns delivered 1 min and 5 rain of the Apgar score; nausea and vomiting, headache, low blood pressure and other adverse reaction. Response and follow2up patients whether there were nervous system syrup toms before they discharged from hospital. Results Two group sin blood pressure, heart rate, pulse oxygen saturation changes, adverse reactions and their newborns deliv2 ered one minute, five minutes of the Apgar score were not significant （P〉 0. 05） . Compared with ep iduralanesthesia, lumbar spinal anesthesia2ep idural anesthesia group and the onset time of narcotic local anes2thetic injection to the fetus delivered significantly shorten the time, anesthetic effect more reliable （P 〈0. 05） . Conclusion Lumbar spinal anesthesia2ep idural anesthesia emergency Cesarean section can beseen as the p referred method of anesthesia.
关键词
剖宫产
手术
麻醉
腰麻-硬膜外联合麻醉
硬膜外麻醉
Cesarean section
Surgical operation
Anaesthesia
Combined spinal/eqidural anesthesia
Eqidural anesthesia
