CAJ | 학술논문

目的：比较妊娠高血压疾病剖宫产术不同麻醉方式的临床效果差异，探讨适合的麻醉方法。方法选择2010年1月至2012年12月210例妊娠高血压疾病剖宫产的产妇作为研究对象，根据个体不同的病情给予不同药物进行镇静、解痉、利尿、降血压、改善心功能等治疗，按患者不同血容量或凝血功能状态，对其施行不同的麻醉方式。结果采用单纯硬膜外麻醉30例，腰麻-硬膜外联合麻醉170例，静脉麻醉10例；均顺利完成手术。单纯硬膜外麻醉在起效慢，平均（735.34±125.56）s、麻醉效果不满意，总有效83.33%；腰麻-硬膜外联合麻醉组低血压发生率较高为17.65%；静脉麻醉组新生儿 Apgar 评分（8.86±0.50）与其他两组（9.01±0.42）、（8.93±0.42）相比偏低，但无显著差异（P ＞0.05）。结论腰麻-硬膜外联合在妊娠高血压疾病剖宫产手术中优势明显，是一种较好的麻醉方法，对于各种原因未能成功实施椎管内麻醉及重症产妇，可选择静脉麻醉。
목적：비교임신고혈압질병부궁산술불동마취방식적림상효과차이，탐토괄합적마취방법。방법선택2010년1월지2012년12월210례임신고혈압질병부궁산적산부작위연구대상，근거개체불동적병정급여불동약물진행진정、해경、이뇨、강혈압、개선심공능등치료，안환자불동혈용량혹응혈공능상태，대기시행불동적마취방식。결과채용단순경막외마취30례，요마-경막외연합마취170례，정맥마취10례；균순리완성수술。단순경막외마취재기효만，평균（735.34±125.56）s、마취효과불만의，총유효83.33%；요마-경막외연합마취조저혈압발생솔교고위17.65%；정맥마취조신생인 Apgar 평분（8.86±0.50）여기타량조（9.01±0.42）、（8.93±0.42）상비편저，단무현저차이（P ＞0.05）。결론요마-경막외연합재임신고혈압질병부궁산수술중우세명현，시일충교호적마취방법，대우각충원인미능성공실시추관내마취급중증산부，가선택정맥마취。
Objective Clinical effect comparison between hypertensive disorder complicating pregnancy cesarean section of different methods of anesthesia, investigate the anesthesia methods. Method Choose January 2010-December 2012 210 cases of pregnant women with cesarean section of the disease of hypertension as the research object, according to the individual condition given different drugs for sedation, antispasmodic, diuretic, reducing blood pressure, improve heart function in patients with different treatment, blood volume or coagulation status, on the implementation of the different ways of anesthesia. Results 30 cases with single epidural anesthesia, combined spinal-epidural anesthesia 170 cases, 10 cases of intravenous anesthesia were successfully completed operation. Epidural anesthesia in the slow onset, averaged (735.34±125.56) s, the anesthetic effect is not satisfactory, the total effective 83.33 %;combined spinal-epidural anesthesia group the incidence of hypotension is high to 17.65 %; intravenous anesthesia group neonatal Apgar score (8.86±0.50) and the other two groups (9.01±0.42), (8.93±0.42) compared with the low, but the differences were not significant (P>0.05). Conclusion combined spinal-epidural hypertensive disorders in cesarean section operation of obvious advantages of pregnancy, it is a better anesthesia way, for various reasons fail to implement successful spinal anesthesia and severe maternal, can choose intravenous anesthesia.