产科子宫切除术的麻醉处理(附31例分析)

Anesthetic management of obstetric hysterectomy-analysis of 31 cases

目的总结分析31例产科子宫切除术的麻醉方法及管理,期待提高该手术麻醉的安全性。方法依据产妇生育史、手术指征、手术和麻醉方法、估计失血量和术中输血补液,以及产妇低血压和血红蛋白等资料进行分析;评估两种麻醉方法的适应证及优缺点。结果脊麻-硬膜外联合麻醉(CSEA)19例(61.29%),全身麻醉(GA)12例(38.71%);未出现1例麻醉死亡病例。结论 CSEA用于这类手术是可取的,但术前已呈休克者宜选用气管内全静脉复合麻醉;并认为这类手术的麻醉管理和术中监测,与麻醉方法的选择是同等重要的。

Objective To analyze 31 cases of obstetric hysterectomy anesthesia and management in the hope of improving the safety of the anesthesia. Methods According to the maternal reproductive history, surgical indications, surgical and anesthetic techniques, estimated blood loss and intraoperative blood transfusion fluid, and maternal hypotension and hemoglobin were analyzed. The indications and the advan- tages and disadvantages of the two anesthetic techniques were evaluated. Results Spinal anesthesia-epidural anesthesia （CSEA） was per- formed in 19 cases （61.29%）, and general anesthesia （GA） was in 12 cases （38.71%）; No case of anesthetic death occurred. Conclusion This study shows that, CSEA applied in this type of surgery is desirable, but endotracheal intravenous anesthesia should be selected before a surgery if there was occurrence of shock; the type of surgery, anesthetic management and intraoperative monitoring, and choice of anesthesia method are equally important.