摘要
目的探讨不同麻醉方法对剖宫产围术期凝血功能及D-二聚体（D—D）影响，为临床麻醉方式提供参考。方法选择120例剖宫产产妇，按照麻醉方式分为观察组与对照组。观察组70例实施腰硬联合麻醉，对照组50例实施硬膜外麻醉，比较两组凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）、D-D、镇痛效果及并发症等临床指标。结果观察组与对照组术前朋、APTT、TT、Fbg组间差异无统计学意义（P〉0．05）；观察组术后6h、术后24hPT、APTT、TT分别为（13．23±1．86）s、（31．18±5．94）s、（15．52±2．55）s，（12．85±1．94）s、（29．74±5．52）s、（14．68±3．15）s，均低于对照组，差异有统计学意义（t=3．294、4．546、4．143、3．656、3．435、3．115，均P〈0．05），术后6h观察组Fbg[（3．17±0．48）g／L]低于对照组，差异有统计学意义（t=3．656，P〈0．05）；观察组D-D术前、术后即刻、术后24h分别为（0．28±0．04）mg／L、（0．33±0．07）mg／L、（0．33±0．07）mg／L，术后相比术前略有上升，但组内对比、与对照组差异均无统计学意义（P〉0．05）；观察组术后疼痛2级、3级发生率分别为41．43％、30．00％，与对照组术后疼痛评级差异均无统计学意义（P〉0．05）；观察组术后未发现深静脉血栓，对照组确诊1例股静脉血栓形成，两组静脉血栓发生率差异无统计学意义（P〉0．05）。结论腰硬联合麻醉、硬膜外麻醉均可预防剖宫产围术期血液高凝状态，降低血栓性并发症发生率，腰硬联合麻醉是首选方法。
Objective To investigate effect of different anesthesia on cesarean section perioperative coagula- tion function and D - dimer, to provide a reference for clinical treatment. Methods 120 cases of cesarean section patients were selected, according to the anesthesia they were divided into observation group and control group. Obser- vation group （70 cases） used combined spinal epidural anesthesia, the control group （50 cases） used epidural anes- thesia. The prothrombin time （ PT）, activated partial thromboplastin time （ APTT）, thrombin time （ TT）, fiber clinical indicators fibrinogen （ Fbg）, DD, analgesia and its complications were compared between the two groups. Results Before surgery, PT, AFYr,rI3＂, Fbg had no statistically significant differences between the two groups （ P 〉 0.05 ）. 6h, 24h after operation, PT,APTT,TF of the observation group were （ 13.23 ± 1.86） s, （31.18 ± 5.94） s, （ 15.52± 2. 55） s; （ 12.85 ±1.94） s, （29.74 ± 5.52） s, （ 14.68 ± 3.15 ） s, which were lower than the control group, the differ- ences were statistically significant （ t = 3. 294,4.546,4. 143,3. 656,3. 435,3.115, all P 〈 0.05 ）. 6h after operation, Fbg of the observation group was （ 3.17±0.48 ） g/L, which was lower than the control group, the difference was statis- tically significant （ t = 3. 656, P 〈 0.05 ） ; D - D of the observation group before surgery, immediately after surgery,24h after surgery were （0.28 ± 0.04） mg/L, 0.04Mg/L, （ 0.33 ＋ 0.07 ） mg/L, （ 0.33 ± 0.07 ） mg/L, compared with the control group had no statistically significant differences （P 〉 0.05 ）. In the observation group, the incidence rates of pain level 2,3 were 41.43% ,30.00%, compared to tile control group showed no significant difference （ P 〉 0.05 ）. Deep vein thrombosis was not found in the observation group, the control group confirmed one case of femoral vein thrombosis,the incidence of venous thrombosis in the two groups showed no significant differ
出处
《中国基层医药》
CAS
2016年第5期765-767,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
麻醉
剖宫产
凝血功能
D-二聚体
Anesthesia
Cesarean section
Coagulation
D - dimer
