穿透性胎盘植入合并凶险型前置胎盘孕妇行剖宫产的麻醉管理(附1例报告)

Anesthesia Management in Cesarean Section for Placenta Percreta Combined with Placenta Previa: Case Report

本文报道2014年5月我科1例穿透性胎盘植入合并凶险型前置胎盘剖宫产手术椎管内麻醉的管理过程。手术顺利,胎儿成功娩出,Apgar评分1 min 4分,5 min 8分。手术时间139 min,术中出血2000 ml,围麻醉期平稳渡过。我们认为术前充分评估患者状况,充分准备,术中合理监测,维持血流动力学稳定,参考Snegovskikh的液体复苏策略,避免出现"致死性三联征"为麻醉管理要点。

In this paper, we reported a patient with placenta percreta combined with placenta previa who received cesarean section under intrathecal anesthesia. The fetus was delivered successfully. The Apgar scores at 1 min and 5 min were 4 and 8, respectively. The period of perianesthesia was stable, and the operation lasted for 139 rain. The total blood loss was 2000 ml. The sufficient preoperative evaluation and preparation and rational monitoring during the operation were critical in order to maintain the stable hemodynamics. We followed the liquid recovery strategy of Snegovskikh for avoiding the deadly triad of hypothermia, metabolic acidosis, and coagulopathy.