腰麻联合硬膜外麻醉在重度妊娠高血压综合征剖宫产中的应用

Application of Combined Spinal-epidural Anesthesia in Parturients with Severe Pregnancy-induced Hypertension Syndrome

目的探讨腰麻联合硬膜外麻醉应用于重度妊娠高血压综合征剖宫产手术的可行性。方法60例ASAⅡ～Ⅲ级需行剖宫产手术的重度妊娠高血压综合征产妇,随机分为腰麻联合硬膜外麻醉(CSEA)组和连续硬膜外麻醉(EA)组各30例。观察并记录麻醉起效时间,VAS评分,下肢运动神经阻滞,最高麻醉平面(T节段),新生儿Apgar评分等方面。结果腰麻联合硬膜外麻醉组麻醉起效时间较短,麻醉效果较好(P<0.05),两组在对新生儿的影响和低血压发生率及血氧饱和度差异无统计学意义(P>0.05)。结论腰麻联合硬膜外麻醉在重度妊娠高血压综合征剖宫产手术麻醉效果好,值得推广。

Objective To evaluate the effectiveness of combined spinal - epidural anesthesia in parturients with severe pregnancy- induced hypertension syndrome. Methods Sixty parturients （ASA Ⅱ --Ⅲ ） with severe pregnancy - induced hypertension syndrome needed to be performed cesarean section were divided into group CSEA （combined spinal - epidural anesthesia, n=30） and group EA （continuous epidural anesthesia, n=30）. The aspects of the time of producing effect, the score of VAS. blockage of lower limb motion, the anesthesia plane, the Apgar score of neonate were observed. Results The time of producing effect in combined spinal - epidural anesthesia was shorter than that in continuous epidural anesthesia. The anesthesia effect in combined spinal- epidural anesthesia was better than that in continuous epidural anesthesia （P〈 0.05）. There was no statistical difference in the Apgar score of neonate, the rate of hypotension and the lower blood oxygen saturation between the two groups （P〉0.05）. Conclusions The effectiveness of combined spinal-epidural anesthesia in parturients with severe pregnancy induced hypertension syndrome is proven to be good and is worth popularizing in clinical application.