摘要
目的探讨不同体重指数(BMI)妊娠高血压产妇的麻醉方法选择。方法选取2015年1月至2019年1月武汉市第五医院诊治的560例妊娠高血压实施剖宫产分娩患者的临床资料进行回顾性分析。根据BMI分为A组(<24.9kg/m^2,n=246)、B组(≥25kg/m^2且≤29.9kg/m^2,n=190)、C组(>29.9kg/m^2,n=124);每组均根据不同麻醉方式再分为三个亚组(硬膜外麻醉:A1/B1/C1组;蛛网膜下腔麻醉:A2/B2/C2组;腰硬联合麻醉:A3/B3/C3组)。比较三组产妇的麻醉效果。结果 ABC三组中各亚组麻醉起效时间、胎头娩出时间、手术时间比较,差异具有统计学意义(P<0.05);其中A3组<A2组<A1组,B3组<B2组<B1组,C3组<C2组<C1组,且A组<B组<C组;△SBP、△DBP比较,A1组<B1组<C1组,差异具有统计学意义(P<0.05),A2组<B2组<C2组,差异具有统计学意义(P<0.05),A3组<B3组<C3组,差异具有统计学意义(P<0.05),且C3组<C2组<C1组,差异具有统计学意义(P<0.05);麻醉不良事件发生率比较,C组均高于A组、B组,差异具有统计学意义(P<0.05);B组和C组出生5min Apgar评分均较1min显著升高,差异具有统计学意义(P<0.05);新生儿Apgar评分比较,A组>B组>C组,差异具有统计学意义(P<0.05),且C3组>C2组>C1组,差异具有统计学意义(P<0.05)。结论对肥胖患者选择腰硬联合麻醉以缩短时间指标,减少血压波动,改善新生儿状况。
Objective To explore the anesthesia methods for pregnant women with pregnancy-induced hypertension and different body mass index(BMI).Methods From January 2015 to January 2019,560 cases of pregnancy induced hypertension diagnosed and treated by the fifth hospital of Wuhan city were selected for retrospective analysis.According to BMI,they were divided into group A(<24.9 kg/m^2,n=246),group B(≥25kg/m^2 and≤29.9kg/m^2,n=190),and group C(>29.9kg/m^2,n=124).Each group was further divided into 3 groups according to different anesthesia methods(epidural anesthesia:A1/B1/C1 group,subarachnoid anesthesia:A2/B2/C2 group,combined spinal-epidural anesthesia:A3/B3/C3 group).The anesthesia effect of puerperant was com-pared among the 3 groups.Results There were significant differences in the onset time of anesthesia,delivery time of fetal head and operation time among the three subgroups(P<0.05),and group A3<A2<A1,B3<B2<B1,C3<C2<C1,and and group A<B<C.Compared with△SBP and△DBP,A1<B1<C1,with statistically significant differences(P<0.05),A2<B2<C2,with statistically significant differences(P<0.05),A3<B3<C3,with statistically significant differences(P<0.05),and C3<C2<C1,with statistically significant differences(P<0.05).The incidences of adverse anesthetic events in group C were higher than those in group A and group B,with statistically significant differences(P<0.05).The 5 min Apgar scores of group B and group C were significantly higher than the 1 minute Apgar scores,with statistically significant differences(P<0.05).Compared with newborn Apgar scores,group A>B>C,with statistically significant differences(P<0.05),and group C3>C2>C1,with statistically significant differences(P<0.05).Conclusions The combined application of spinal-epidural anesthesia is referred for obese patients to shorten the time,reduce blood pressure fluctuation and improve the condition of newborns.
作者
杨声涛
郭一新
YANG Shengtao;GUO Yixin(Department of Anesthesiology,Fifth Hospital of Wuhan,Wuhan 430000,Hubei,China)
出处
《中国性科学》
2020年第9期54-58,共5页
Chinese Journal of Human Sexuality
关键词
体重指数
妊娠
高血压
剖宫产
麻醉
Body mass index(BMI)
Pregnancy
Hypertension
Cesarean section
Anesthesia
