腰硬联合麻醉用于中重度妊高征剖宫产手术的临床研究

Clinical Observation of Combined Spinal and Epidural Anesthesia in Caesarean Sections with Moderate and Severe Pregnancy-induced Hypertension

目的探讨腰硬联合麻醉用于中重度妊高征剖宫产手术的可行性。方法择期剖宫产手术的中重度妊高征产妇60例,随机分为腰麻组和腰硬联合麻醉组(联合组),观察两组血压、心率的变化,术中镇痛效果,胎儿娩出情况及麻醉药不良反应。结果联合组低血压、头痛的发生率低(P<0.05),但两组胎儿的娩出时间和出生时Apgar评分无统计学差异(P>0.05)。结论腰硬联合麻醉血流动力学影响小,低血压、头痛发生率低,对中重度妊高征剖宫产手术而言,是一种较合理的麻醉方法。

Objective To investigate the effect of combined spinal and epidural anesthesia in caesarean section with moderate and severe pregnancy-induced hypertension（PIH）. Method 60 patients of moderate and severe PIH were randomized into 2 groups with 30 of each, using combined spinal and epidural anesthesia, and spinal anesthesia alone. Results In the combined group, the hypotension and headache rates were lower than those of the spinal anesthesia group（ P 〈 0.05 ） ,while the fetal expulsion time and Apgar score were similar （ P 〉 0.05 ）. Conclusion Combined spinal and epidural anesthesia in caesarean section are suitable for patients with moderate and severe PIH, with the advantages of less influence to hemodynamics, low morbidity of hypotension and headache.