摘要
目的:分析两点法腰麻-硬膜外联合麻醉在剖宫产手术中的麻醉效果及安全性。方法:选取108例剖宫产孕妇为研究对象,按照麻醉方案的不同分为研究组(n=55)和对照组(n=53)。研究组接受两点法腰麻-硬膜外联合麻醉(DST);对照组接受单点法腰麻-硬膜外联合麻醉(SST)。比较两组产妇麻醉前(T_(0))、给药后5 min(T_(1))、给药后15 min(T_(2))、给药后30 min(T_(3))、手术结束(T_(4))时平均动脉压(MAP)、心率(HR)、去甲肾上腺素和皮质醇水平;麻醉效果、牵拉反应和松弛程度;运动恢复时间(腰麻注药完毕至改良Bromage评分恢复至0级的时间);痛觉恢复时间(腰麻注药完毕至切口开始疼痛的时间);不良反应发生情况。结果:研究组与对照组产妇基础HR、MAP比较,差异无统计学意义(P>0.05)。给药后,对照组HR在T_(1)上升,且研究组低于对照组(P<0.05);T_(2)~T_(4)时两组产妇HR比较,差异无统计学意义(P>0.05);MAP呈上升趋势,且T_(1)~T_(4)时研究组MAP低于对照组(P<0.05)。两组产妇在T_(0)时的去甲肾上腺素和皮质醇水平比较,差异无统计学意义(P>0.05);给药后,两组产妇去甲肾上腺素和皮质醇水平均升高,且T_(1)~T_(4)时研究组去甲肾上腺素和皮质醇水平低于对照组(P<0.05)。两组产妇麻醉效果、牵拉反应和松弛程度比较,差异有统计学意义(P<0.05)。研究组产妇运动恢复时间少于对照组(P<0.05);痛觉恢复时间长于对照组(P<0.05);不良反应发生率低于对照组(P<0.05)。结论:剖宫产术中应用DST可减轻产妇的应激反应,加速下肢运动恢复,麻醉效果确切,且安全性高,值得推广。
Objective:To analyze the anesthesia effect and safety of combined spinal-epidural anesthesia with two-point method in cesarean section.Methods:A total of 108 pregnant women were selected as the research subjects and divided into the research group and the control group according to the different anesthesia schemes.55 cases in the study group were under the combined spinal-epidural anesthesia with two-point method(DST).53 cases of control group were treated with single-point lumbar anesthesia combined with epidural anesthesia(SST).The mean arterial pressure(MAP),heart rate(HR),norepinephrine,cortisol levels before anesthesia(T_(0)),5 min after drug administration(T_(1)),15 min after drug administration(T_(2)),30 min after drug administration(T_(3)),and at the end of surgery(T_(4)),anesthesia effect,traction reaction and relaxation degree of the parturients,ogether with the movement recovery time(the time from the completion of lumbar anesthesia drug injection to the recovery of modified Bromage score to level 0),pain recovery time(the time from the completion of lumbar anesthesia drug injection to the start of incision pain)and adverse reactions were compared between the two groups.Results:There was no difference in basic HR and MAP between the study group and the control group(P>0.05).After administration,HR of the control group increased at T_(1),and HR of the research group at T_(1) was lower than that in the control group(P>0.05).There was no significant difference in HR between the two groups at T_(2)~T_(4)(P>0.05).After administration,MAP showed an upward trend,and the MAP of the study group was lower than that of the control group at T_(1)~T_(4)(P<0.05).There was no difference in the levels of norepinephrine and cortisol at T_(0) between the two groups(P>0.05).After drug administration,the norepinephrine and cortisol levels in the two groups were increased,and the norepinephrine and cortisol levels in the research group were lower than those in the control group from T_(1)~T_(4)(P<0.05).There were significa
作者
吴昊
石军
况雪静
WU Hao;SHI Jun;KUANG Xue-jing(Department of Anesthesiology,the First Affiliated Hospital of Anhui University of technology,Huainan 232001,Anhui,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui University of technology,Huainan 232001,Anhui,China)
出处
《川北医学院学报》
CAS
2022年第8期1050-1054,共5页
Journal of North Sichuan Medical College
基金
安徽省2019年度科研和技术项目(2019WWBF02)。
关键词
剖宫产
腰麻-硬膜外联合麻醉
两点法
应激反应
麻醉效果
Cesarean section
Combined spinal-epidural anesthesia
Double-segment technique
Stress response
Anesthetic effect
