环球中医药
環毬中醫藥
배구중의약
GLOBAL TCM
2013年
z2期
173-174
,共2页
腰麻联合硬膜外麻醉%硬膜外麻醉%分娩镇痛
腰痳聯閤硬膜外痳醉%硬膜外痳醉%分娩鎮痛
요마연합경막외마취%경막외마취%분면진통
Combined spinal epidural anesthesia%Epidural anesthesia%Labour analyesia
目的：比较腰麻联合硬膜外麻醉（CSEA）与硬膜外麻醉（CEA）用于分娩镇痛的效果。方法选择产妇60例，随机均分成腰麻联合硬膜外麻醉CSEA组30例（A组）和单纯硬膜外麻醉CEA组30例（B组）。A组蛛网膜下腔注入0.1％罗哌卡因2mg和芬太尼25ug ，然后硬膜外腔置入导管3cm ，B组硬膜外穿刺置管成功，经硬膜外导管注入0.1％罗哌卡因和芬太尼2ug/ml总量20ml。两组完成均经硬膜外导管接上微量泵（PCA），以6ml/h的速度0.1％罗哌卡因＋芬太尼0.2mg 50ml泵入。记录镇痛效果、麻醉前后血流动力学改变、产程、产后出血量及新生儿Apgar评分、产妇对镇痛效果评估、运动神经阻滞情况以及并发症。结果两组病人年龄、体重、身高、孕期无明显差异（P＜0.05），麻醉 HR、MAP相同，镇痛效果A组I级多于B组（P＜0.05），产妇自我评估达到I级无明显差异（P＜0.05），运动神经阻滞无明显差异，两组新生儿Apgar评分[1]无差异，未出现并发症。结论腰麻联合硬膜外麻醉（CSEA）与单纯硬膜外（CEA）麻醉用于分娩镇痛效果满意，但CSEA镇痛效果更好。
目的：比較腰痳聯閤硬膜外痳醉（CSEA）與硬膜外痳醉（CEA）用于分娩鎮痛的效果。方法選擇產婦60例，隨機均分成腰痳聯閤硬膜外痳醉CSEA組30例（A組）和單純硬膜外痳醉CEA組30例（B組）。A組蛛網膜下腔註入0.1％囉哌卡因2mg和芬太尼25ug ，然後硬膜外腔置入導管3cm ，B組硬膜外穿刺置管成功，經硬膜外導管註入0.1％囉哌卡因和芬太尼2ug/ml總量20ml。兩組完成均經硬膜外導管接上微量泵（PCA），以6ml/h的速度0.1％囉哌卡因＋芬太尼0.2mg 50ml泵入。記錄鎮痛效果、痳醉前後血流動力學改變、產程、產後齣血量及新生兒Apgar評分、產婦對鎮痛效果評估、運動神經阻滯情況以及併髮癥。結果兩組病人年齡、體重、身高、孕期無明顯差異（P＜0.05），痳醉 HR、MAP相同，鎮痛效果A組I級多于B組（P＜0.05），產婦自我評估達到I級無明顯差異（P＜0.05），運動神經阻滯無明顯差異，兩組新生兒Apgar評分[1]無差異，未齣現併髮癥。結論腰痳聯閤硬膜外痳醉（CSEA）與單純硬膜外（CEA）痳醉用于分娩鎮痛效果滿意，但CSEA鎮痛效果更好。
목적：비교요마연합경막외마취（CSEA）여경막외마취（CEA）용우분면진통적효과。방법선택산부60례，수궤균분성요마연합경막외마취CSEA조30례（A조）화단순경막외마취CEA조30례（B조）。A조주망막하강주입0.1％라고잡인2mg화분태니25ug ，연후경막외강치입도관3cm ，B조경막외천자치관성공，경경막외도관주입0.1％라고잡인화분태니2ug/ml총량20ml。량조완성균경경막외도관접상미량빙（PCA），이6ml/h적속도0.1％라고잡인＋분태니0.2mg 50ml빙입。기록진통효과、마취전후혈류동역학개변、산정、산후출혈량급신생인Apgar평분、산부대진통효과평고、운동신경조체정황이급병발증。결과량조병인년령、체중、신고、잉기무명현차이（P＜0.05），마취 HR、MAP상동，진통효과A조I급다우B조（P＜0.05），산부자아평고체도I급무명현차이（P＜0.05），운동신경조체무명현차이，량조신생인Apgar평분[1]무차이，미출현병발증。결론요마연합경막외마취（CSEA）여단순경막외（CEA）마취용우분면진통효과만의，단CSEA진통효과경호。
Objective Comparison of the influence of combined spinal epidural anesthesia and epidural anesthesia in obstetrical .Methods Sixty puerperal lying-in women were andomly divided into two groups :combined spinal epidural anesthesia 30 (group A) and epidural anesthesia 30 (group B) .Puerperal lying-in women-controlled spinal analgesia with 0.1% ropacaine 2mg and fentyl 25ug were gived in goup A ,and placed in epi-dural with 3cm catheter .Puerperal lying-in women-controlled epidural analgesia were placed in epidural with 3cm catheter in goup B ,and gived with 0.1% ropacaine and fentyl 2ug/ml 20ml in epidual .Two groups were connected with PCA in epidural catheter .PCA with 0.1% ropacaine and fentyl 0.2mg 50ml go under 6ml/h speed .Two groups were recorded analyesia influence 、blood flow dynamics learing change before and after anesthesia、labor、postpartum haemorrhage amount、the newborn Apgar score、puerperal lying-in woman evaluated analyesia influence、motor nerve block situa-tion and complications .Results HR and MAP decreased in group A with group B (P<0.05) ,age ,weight ,height ,during pregnancy (P<0.05) , motor nerve block I in group A was more than group B (P<0.05) ,puerperal lying-in woman evaluated the same analyesia influence I in two groups , the newborn Apgar score no difference between ,without complications .Conclusion The influence of combined spinal epidural anesthesia and epi-dural anesthesia in obstetrical is satisfactory ,but CSEA has higer influence in labour analyesia .
