摘要
目的:比较罗哌卡因与布比卡因对妊娠期合并心血管疾病患者终止妊娠手术的麻醉效果。方法:纳入2019年1月-2021年1月在本院实施终止妊娠手术的妊娠期合并心血管疾病患者120例,按入院时间随机分为对照组和观察组各60例,两组均实施刮宫手术,对照组给予布比卡因、观察组给予罗哌卡因。比较两组麻醉效果、宫颈扩张难度、术后30min下腹疼痛程度、Bromage评分、围术期出血量、生命指证、心肌酶[乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)]、脑钠肽(BNP)、心电图及不良反应。结果:宫颈扩张及麻醉效果、术后疼痛程度两组均无差异(P>0.05)。术后Bromage评分0级、Ⅰ级、Ⅱ级、Ⅲ级对照组分别为11.1%、46.0%、34.9%、3.2%,观察组分别为63.5%、30.2%、1.6%、0例,观察组0级、I级优于对照组(P<0.05)。两组术中出血量、手术时间及停药至唤醒时间无差异(P>0.05),离院时间观察组(45.4±11.0min)少于对照组(50.2±12.6min)(P<0.05)。两组围术期血压、心率和指脉氧饱和度无差异(P>0.05),观察组LDH、CK、CK-MB、AST和BNP均低于对照组(P<0.05)。两组围术期心电图异常发生无差异(P>0.05)。观察组围术期不良反应(6.7%)少于对照组(17.1%)(P<0.05)。结论:妊娠期合并心血管疾病患者终止妊娠手术中,罗哌卡因和布比卡因麻醉效果相当,但罗哌卡因对心肌酶及BNP的影响更小,不良反应减少,术后恢复更快。
Objective:To compare the anesthetic effect of ropivacaine and bupivacaine used during the pregnancy termination surgery of pregnant women with cardiovascular diseases.Methods:120pregnant women with cardiovascular diseases who wanted pregnancy termination surgery were included in this study from January 2019to January 2021.According to the admission time,these women were randomly divided into two groups(60cases in each group).The women in the control group were given bupivacaine for anesthetic during surgery and the women in the observation group were given ropivacaine for anesthetic during surgery.The anesthetic effect,the difficulty of cervical dilatation,the degree of lower abdominal pain and Bromage score at 30minutes after surgery,the perioperative bleeding volume,the vital signs,and the levels of myocardial enzyme spectrum,such as lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme MB(CK-MB),and aspartate aminotransferase(AST),the brain natriuretic peptide(BNP)level,the electrocardiogram result,and the adverse reactions rate of the women were compared between the two groups.Results:There were no significant differences in the cervical dilation,the anesthesia effect,and the postoperative pain degree of the women between the two groups(P>0.05).After operation,the rates of Bromage scores of grade 0,grade Ⅰ,grade Ⅱ,and grade Ⅲ of the women in the control group in the observation group were 11.1%,46.0%,34.9%,and 3.2%,respectively,and which of the women in the observation group were 63.5%,30.2%,1.6%,and 0,respectively.The grade 0and grade I of the women in the observation group were significantly better than those of the women in the control group(P<0.05).There were no significant differences in the amount of blood loss,the operation time,and the time from drug withdrawal to awakening of the women between the two groups(P>0.05).The time of discharge from hospital of the women in the observation group was significantly less than that of the women in the control group(P<0.05).There were no
作者
艾琦杰
蒋伊宁
周红梅
AI Qijie;JIANG Yining;ZHOU Hongmei(Jiaxing Second Hospital,Jiaxing,Zhejiang Province,314000)
出处
《中国计划生育学杂志》
2023年第9期2083-2089,共7页
Chinese Journal of Family Planning
关键词
终止妊娠手术
合并心血管疾病
罗哌卡因
布比卡因
麻醉效果
术后恢复
不良反应
Pregnancy termination surgery
Complicating with cardiovascular disease
Ropivacaine
Bupivacaine
Anesthetic effect
Postoperative recovery
Adverse reaction
