CAJ | 학술논문

目的研究腰麻‐硬脊膜外联合阻滞麻醉对妊娠高血压综合征产妇的镇痛效果及安全性。方法选取我院180例单胎、足月、合并高血压的产妇自愿选择腰麻‐硬脊膜外联合阻滞麻醉分娩镇痛作为研究组，以同期分娩的180例单胎、足月正常产妇进行分娩镇痛为对照组。镇痛效果评定选用VAS评分系统，通过比较2组各产程时间、产后出血量、分娩方式、产妇血压、心率、呼吸、血氧饱和度变化及胎儿窘迫与新生儿窒息的发生率，进行母婴安全性的分析。结果腰麻‐硬脊膜外联合阻滞麻醉对妊娠高血压综合征产妇分娩镇痛效果显著。与对照组相比，第2产程时间短，差异具有统计学意义，其余产程时间差异无统计学意义；研究组与对照组的胎儿窘迫、新生儿窒息的发生率差异无统计学意义；与对照组分娩方式相比，研究组阴道助产例数多、顺产例数少，差异具有统计学意义；研究组与对照组的呼吸、心率、血氧饱和度差异无统计学意义；与对照组血压相比，研究组血压受影响例数多，差异具有统计学意义。结论腰麻‐硬脊膜外联合阻滞麻醉对妊娠高血压综合征产妇镇痛效果满意，对母婴相对安全，提高了此病的自然分娩率。
목적연구요마‐경척막외연합조체마취대임신고혈압종합정산부적진통효과급안전성。방법선취아원180례단태、족월、합병고혈압적산부자원선택요마‐경척막외연합조체마취분면진통작위연구조，이동기분면적180례단태、족월정상산부진행분면진통위대조조。진통효과평정선용VAS평분계통，통과비교2조각산정시간、산후출혈량、분면방식、산부혈압、심솔、호흡、혈양포화도변화급태인군박여신생인질식적발생솔，진행모영안전성적분석。결과요마‐경척막외연합조체마취대임신고혈압종합정산부분면진통효과현저。여대조조상비，제2산정시간단，차이구유통계학의의，기여산정시간차이무통계학의의；연구조여대조조적태인군박、신생인질식적발생솔차이무통계학의의；여대조조분면방식상비，연구조음도조산례수다、순산례수소，차이구유통계학의의；연구조여대조조적호흡、심솔、혈양포화도차이무통계학의의；여대조조혈압상비，연구조혈압수영향례수다，차이구유통계학의의。결론요마‐경척막외연합조체마취대임신고혈압종합정산부진통효과만의，대모영상대안전，제고료차병적자연분면솔。
Objective To explore the analgesia effect and safety of combined spinal epidural anesthesia in parturients with gestational hypertension .Methods 180 normal term parturients with gestational hypertension and 180 normal term pregnancy parturients , both with single vertex presentation ,were divided into 2 groups ,study group and control group The analgesic effect was evaluated using VAS scoring system .The maternal and child safety were analyzed through the comparison of labor time ,postpartum hemor‐rhage ,mode of delivery ,maternal blood pressure ,heart rate ,respiration ,the change in blood oxygen saturation ,fetal distress and neonatal asphyxia rate in the 2 groups .Results The analgesia effect of combined spinal epidural anesthesia was significant . The difference of the second stage of labor time between the 2 groups was significant ,and the study group was shorter .The difference of the child birth time between the 2 groups was not significant at all .The difference of the fetal distress ,neonatal as‐phyxia rate ,respiration ,heart rate ,oxygen saturation between the 2 groups was not significant at all .The difference of the deliv‐ery mode between the two groups was significant .The cases of vaginal delivery were more and the cases of natural labor were less in the study group .The difference of influenced blood pressure between the 2 groups was significant ,the study group wes more . Conclusion Combined spinal epidural anesthesia can be used for the parturients with gestational hypertension .It is relatively safe and could improve the rate of natural birth rate .