妊娠合并肺动脉高压麻醉的临床分析

Clinical analysis of pulmonary hypertension during pregnancy

目的观察低剂量椎管内麻醉联合伊洛前列素和全身麻醉联合前列腺环素用于妊娠合并肺动脉高压麻醉的临床效果,以及两者的优点及区别。方法对40例经临床明确诊断为妊娠合并肺动脉高压,同时要进行剖宫产手术的产妇随机分为A组和B组,每组分别为20例。麻醉方法和降低肺动脑高压的药物选择分别为:A组产妇采取低剂量椎管内麻醉联合伊洛前列素的方法;B组产妇采取全身麻醉联合前列腺环素的方法,观察其麻醉效果及对产妇在分娩过程中出血量及肺动脉高压的控制情况。结果 A组和B组研究对象在阻滞起效、阻滞完全时间及麻醉效果方面,低剂量椎管内麻醉联合伊洛前列素的麻醉效果明显好于全身麻醉联合前列腺环素组,差异有统计学意义(P<0.05),同时,低剂量椎管内麻醉联合伊洛前列素组研究对象在分娩中的出血量少于全身麻醉联合前列腺环素组,差异有统计学意义(P<0.05)。结论在对接受妊娠合并肺动脉高压产妇进行剖宫产手术时,采用低剂量椎管内麻醉联合伊洛前列素的麻醉方式较全身麻醉联合前列腺环素的麻醉效果更好。

Objective To observe the intraspinal anesthesia combined with low dose of iloprost and combined general anesthesia for prostate in the clinical effect of pulmonary hypertension during pregnancy anesthesia, and the advantages and the difference between the two. Methods 40 patients with clinical diagnosis of pulmonary hypertension during pregnancy, and at the same time to caesarean operation were randomly divided into A group and B group, each group were 20 cases. Methods of anesthesia and drugs that reduce lung brain pressure selection. were：group A were taken with iloprost anesthesia low-dose spinal;group B were taken under general anesthesia in combination with prostacyclin method, the effect of topical anesthesia and to control the amount of pulmonary hypertension and the parturient bleeding. Results A group and B group were studied completely in block onset time, block andanesthesia effect, low dose spinal anesthesia combined with iloprost anesthesia is better thangeneral anesthesia combined with prostacyclin group （P〈0.05）, at the same time, amount of bleeding and low dose spinal anesthesia combined with iloprost group of participants in the study labor is less than that in general anesthesia combined with prostacyclin group （P〈0.05）.Conclusion The cesarean section operation to accept pulmonary hypertension complicating pregnancy maternal, better anesthesia effect with low dose spinal anesthesia combined withiloprost anesthesia with general anesthesia combined with prostaglandin.