当代医学
噹代醫學
당대의학
Contemporary Medicine
2015年
31期
27-28
,共2页
小针%脊麻针%剖宫产
小針%脊痳針%剖宮產
소침%척마침%부궁산
Small needle%Spinal anesthesia needles%Cesarean
目的：探索9号小针引导25G（0.5mm）脊麻针在剖宫产中的应用。方法择期单胎足月剖宫产产妇200例，ASAⅠ～Ⅱ级，随机均分为R、H组（n=100）。R组常规于L 3～4间隙正中入路行硬膜外和腰麻联合麻醉，术毕硬膜外术后镇痛。H组使用9号小针引导25 G（0.5 mm）脊麻针于L 3～4间隙正中入路行单次腰麻，术毕行静脉术后镇痛。观察2组间穿刺操作时间，穿刺成功率，麻醉前（T 1）、麻醉后2 min（T 2）及手术后（T 3）血流动力学指标，术后24h及72h背痛率，从穿刺疼痛、术中疼痛及术后疼痛等方面评价患者满意率。结果2组间产妇年龄、孕周、体质量、麻醉平面、心率差异无统计学意义；组内比较患者术中血流动力学：与T1相比，T2时患者血压下降(P<0.05)；与R组相比，H组麻醉操作时间降低(6.5±2.2min vs 15.8±3.5min,P<0.05)，术后背痛率降低(P<0.05)，患者满意度增高(99% vs 91%,P<0.05)。结论9号小针引导25G（0.5mm）脊麻针在剖宫产中的应用有明显的优越性，可以推广。
目的：探索9號小針引導25G（0.5mm）脊痳針在剖宮產中的應用。方法擇期單胎足月剖宮產產婦200例，ASAⅠ～Ⅱ級，隨機均分為R、H組（n=100）。R組常規于L 3～4間隙正中入路行硬膜外和腰痳聯閤痳醉，術畢硬膜外術後鎮痛。H組使用9號小針引導25 G（0.5 mm）脊痳針于L 3～4間隙正中入路行單次腰痳，術畢行靜脈術後鎮痛。觀察2組間穿刺操作時間，穿刺成功率，痳醉前（T 1）、痳醉後2 min（T 2）及手術後（T 3）血流動力學指標，術後24h及72h揹痛率，從穿刺疼痛、術中疼痛及術後疼痛等方麵評價患者滿意率。結果2組間產婦年齡、孕週、體質量、痳醉平麵、心率差異無統計學意義；組內比較患者術中血流動力學：與T1相比，T2時患者血壓下降(P<0.05)；與R組相比，H組痳醉操作時間降低(6.5±2.2min vs 15.8±3.5min,P<0.05)，術後揹痛率降低(P<0.05)，患者滿意度增高(99% vs 91%,P<0.05)。結論9號小針引導25G（0.5mm）脊痳針在剖宮產中的應用有明顯的優越性，可以推廣。
목적：탐색9호소침인도25G（0.5mm）척마침재부궁산중적응용。방법택기단태족월부궁산산부200례，ASAⅠ～Ⅱ급，수궤균분위R、H조（n=100）。R조상규우L 3～4간극정중입로행경막외화요마연합마취，술필경막외술후진통。H조사용9호소침인도25 G（0.5 mm）척마침우L 3～4간극정중입로행단차요마，술필행정맥술후진통。관찰2조간천자조작시간，천자성공솔，마취전（T 1）、마취후2 min（T 2）급수술후（T 3）혈류동역학지표，술후24h급72h배통솔，종천자동통、술중동통급술후동통등방면평개환자만의솔。결과2조간산부년령、잉주、체질량、마취평면、심솔차이무통계학의의；조내비교환자술중혈류동역학：여T1상비，T2시환자혈압하강(P<0.05)；여R조상비，H조마취조작시간강저(6.5±2.2min vs 15.8±3.5min,P<0.05)，술후배통솔강저(P<0.05)，환자만의도증고(99% vs 91%,P<0.05)。결론9호소침인도25G（0.5mm）척마침재부궁산중적응용유명현적우월성，가이추엄。
Objective To explore the 9th small needle guide 25G (0.5mm) needles used in spinal anesthesia in cesarean section.Methods Elective single embryo term cesarean section 200 cases, ASAⅠ-Ⅱ, were randomly average divided into group R and group H. Maternal were accepted in accordance with conventional methods of epidural and spinal anesthesia in group R. Epidural analgesia were used after surgery. Maternal were accepted the 9th small needle guide 25G (0.5mm) gap spinal anesthesia needle in the middle of the road trip L3-4 single spinal anesthesia. Intravenous postoperative analgesia were used after surgery. Puncture operation time, success rate, changes in hemodynamics before anesthesia (T1), after anesthesia 2min (T2) and after surgery (T3), 24h and 72h after back pain rate from puncture pain were observed between two groups. Evaluation of patient satisfaction rate from the puncture pain, intraoperative and postoperative pain.Results Maternal age, gestational age, weight, anesthesia, heart rate were no signiifcant difference between two groups. The blood pressure drops in T2 when compared with T1(P<0.05). Compared with the group R, the operation time of anesthesia decreased (P<0.05), Lower back pain after surgery (P<0.05), patient satisfaction increased (P<0.05) in group H.Conclusion The 9th small needle guide 25G (0.5mm) needles used in spinal anesthesia in cesarean section has obvious advantages, can be extended.
