中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
13期
12-14
,共3页
腰-硬联合麻醉%单纯硬膜外麻醉%左旋布比卡因%剖宫产
腰-硬聯閤痳醉%單純硬膜外痳醉%左鏇佈比卡因%剖宮產
요-경연합마취%단순경막외마취%좌선포비잡인%부궁산
Combined spinal-epidural anesthesia%Epidural anesthesia%Levobupivacaine%Cesarean section
目的 比较腰-硬联合阻滞与单纯硬膜外阻滞两种麻醉方法在剖宫产手术中的应用.方法 选取100例ASA Ⅰ～Ⅱ级的剖宫产手术患者,随机分为腰-硬联合麻醉组(观察组)和单纯硬膜外麻醉组(对照组),观察记录麻醉前及麻醉给药后10 min患者收缩压、舒张压及心率变化；记录麻醉给药至手术开始的时间、麻醉给药至胎儿娩出时间(I-D时间)、最高麻醉阻滞平面；记录术中局麻药用量、新生儿出生后1 min和5 min的Apgar评分；观察术中麻醉效果及患者恶心呕吐、心动过缓、术中寒颤等不良反应发生情况.结果 观察组患者麻醉给药10 min后收缩压、舒张压及心率下降较对照组及麻醉给药前显著,与给药前及对照组比较差异有统计学意义(P＜0.05)；观察组麻醉镇痛效果明显优于对照组,两组比较差异有统计学意义(P＜0.05)；观察组麻醉起效时间、I-D时间均短于对照组、局麻药用量显著少于对照组,两组比较差异有统计学意义(P＜0.05)；观察组应用麻黄碱例数明显多于对照组,两组比较差异有统计学意义(P＜0.05).结论 腰-硬联合麻醉起效快、麻醉效果确切、用药量少、术中镇痛效果好、不良反应少、对新生儿无不良影响,是剖宫产手术的较佳选择.
目的 比較腰-硬聯閤阻滯與單純硬膜外阻滯兩種痳醉方法在剖宮產手術中的應用.方法 選取100例ASA Ⅰ～Ⅱ級的剖宮產手術患者,隨機分為腰-硬聯閤痳醉組(觀察組)和單純硬膜外痳醉組(對照組),觀察記錄痳醉前及痳醉給藥後10 min患者收縮壓、舒張壓及心率變化；記錄痳醉給藥至手術開始的時間、痳醉給藥至胎兒娩齣時間(I-D時間)、最高痳醉阻滯平麵；記錄術中跼痳藥用量、新生兒齣生後1 min和5 min的Apgar評分；觀察術中痳醉效果及患者噁心嘔吐、心動過緩、術中寒顫等不良反應髮生情況.結果 觀察組患者痳醉給藥10 min後收縮壓、舒張壓及心率下降較對照組及痳醉給藥前顯著,與給藥前及對照組比較差異有統計學意義(P＜0.05)；觀察組痳醉鎮痛效果明顯優于對照組,兩組比較差異有統計學意義(P＜0.05)；觀察組痳醉起效時間、I-D時間均短于對照組、跼痳藥用量顯著少于對照組,兩組比較差異有統計學意義(P＜0.05)；觀察組應用痳黃堿例數明顯多于對照組,兩組比較差異有統計學意義(P＜0.05).結論 腰-硬聯閤痳醉起效快、痳醉效果確切、用藥量少、術中鎮痛效果好、不良反應少、對新生兒無不良影響,是剖宮產手術的較佳選擇.
목적 비교요-경연합조체여단순경막외조체량충마취방법재부궁산수술중적응용.방법 선취100례ASA Ⅰ～Ⅱ급적부궁산수술환자,수궤분위요-경연합마취조(관찰조)화단순경막외마취조(대조조),관찰기록마취전급마취급약후10 min환자수축압、서장압급심솔변화；기록마취급약지수술개시적시간、마취급약지태인면출시간(I-D시간)、최고마취조체평면；기록술중국마약용량、신생인출생후1 min화5 min적Apgar평분；관찰술중마취효과급환자악심구토、심동과완、술중한전등불량반응발생정황.결과 관찰조환자마취급약10 min후수축압、서장압급심솔하강교대조조급마취급약전현저,여급약전급대조조비교차이유통계학의의(P＜0.05)；관찰조마취진통효과명현우우대조조,량조비교차이유통계학의의(P＜0.05)；관찰조마취기효시간、I-D시간균단우대조조、국마약용량현저소우대조조,량조비교차이유통계학의의(P＜0.05)；관찰조응용마황감례수명현다우대조조,량조비교차이유통계학의의(P＜0.05).결론 요-경연합마취기효쾌、마취효과학절、용약량소、술중진통효과호、불량반응소、대신생인무불량영향,시부궁산수술적교가선택.
Objective To compare the application of combined spinal-epidural anesthesia and epidural anesthsia in cesarean section.Methods One hundred cases of ASA Ⅰ-Ⅱ level cesarean section patients were randomly divided into spinal-epidural anesthesia group (observation group) and epidural anesthesia alone (control group).Systolic blood pressure,diastolic blood pressure and heart rate changes were observed and recorded before anesthesia and 10 min after the administration of anesthesia in patients.The time from anesthesia administered to the start of the surgery,the anesthesia administered to the fetus (I-D time),the highest anesthetic block plane were recorded.Intraoperative local anesthetic dosage,Apgar score 1 min and 5 min after birth were recorded.Intraoperative anesthetic effect and patients with adverse reaction such as nausea and vomiting,bradycardia,intraoperative chills were observed.Results The systolic blood pressure,diastolic blood pressure and heart rate decreased significantly 10 min after anesthesia administered in observation group,compared with the control group and before anesthesia administered,the difference was statistically significant (P ＜ 0.05).Narcotic analgesic effect of observation group was significantly better than that of control group,the difference was statistically significant (P ＜ 0.05).The onset time,I-D of observation group were shorter than those of control group,the amount of local anesthetic was significantly less than those in control group,the difference was statistically significant(P ＜ 0.05).The number of cases using ephedrine in observation group was significantly more than that in control group (P ＜ 0.05).Conclusions The anesthesia effect of combined spinal-epidural anesthesia is exact and it has rapid onset,less dosage,good intraoperative analgesia effect,less adverse reaction,no side effect on neonate,which is a better choice for cesarean section operation.
