90例心脏病人剖宫产围手术期处理和麻醉观察

Peroperative management and anesthesiaof cesarean section for cardiopath

目的 探讨心脏病人施行剖宫术最佳围手术期的治疗及麻醉处理 ,有效地提高母婴生存率。方法 随机选择 90例心脏病剖宫手术病人进行围手术期治疗、麻醉处理及监测部分病例进行术前、术中、术后血流动力学指标等项目监测。结果 硬膜外阻滞后 33例出现低血压 ,平均收缩压下降 2 .7～ 4.0kPa ,中心静脉压无明显影响 ;血流动力学指标改变 ,心律失常发生率与心脏病类型有关。结论 在适当纠正条件和心电监测下对心脏病人行剖宫产术更为安全 ,可有效地防止急性心力衰竭的发生 ;硬膜外连续阻滞麻醉施行剖宫产术尤为适用于高危妊娠心脏病人的剖腹产 ;心脏病人行剖宫术围手术期密切监测血流动力学指标和心血管功能可有效地提高母婴安全。

Objectives To discuss the best peroperative cure and anesthetic management so as to elevate the survival rate of parturients and infants.Methods Peroperative cure, anesthetic management and surveillance of preoperative, in-operation and postoperative hemodynamic indexes were given to 90 randomized cardiopathes who underwent cesarean section.Results 33 patients with continuous epidural anesthesia had got hypotension. The decreased average systolic pressure ranged from 2.7 to 4.0 kPa, while the CVP had no change;hemodynamic indexes change,and arhythmia incidence was relative with the type of cardiopathy.Conclusions Cesarean section is much safer for cardiopathes with some certain preative cure and ECG surveillance,which can prevent acute heart failure effectively.The cesarean section with continuous epidural anesthesia is espescially suitable for high risk gravida with cardiopathy.Continual surveillance of hemodynamic indexes and cardiovascular function during and infants.