腰-硬联合麻醉与硬膜外麻醉对子痫前期患者围术期血流动力学的影响

Spinal-epidural anesthesia and epidural anesthesia on perioperative hemodynamics in patients with preeclampsia

目的对比腰-硬联合麻醉与硬膜外麻醉对子痫前期患者围术期血流动力学的影响。方法 60例子痫前期产妇根据随机抽签原则分为治疗组与对照组各30例,所有患者都采用剖宫产术终止妊娠,治疗组给予腰-硬联合麻醉,对照组给予连续硬膜外麻醉。结果治疗组的感觉阻滞起效时间、达到阻滞平面T10时间、达到阻滞平面T8时间与达到最高阻滞平面时间都明显少于对照组(P<0.05)。术后治疗组的肌肉松弛程度与牵拉反应程度明显好于对照组(P<0.05)。同时所有患者在围术期保持血流动力学稳定,无明显波动,处于正常状况。结论相对于硬膜外麻醉,腰-硬联合麻醉在子痫前期患者的应用对血流动力学无明显影响,能有效发挥阻滞效果,肌肉松弛与牵拉反应程度低,值得推广应用。

Objective To compare spinal-epidural anesthesia and epidural anesthesia on perioperative hemodynamics in patients with preeclampsia. Methods60 women with preeclampsia were divided into treatment group and control group （30 women） based on the principle of a random draw, all patients were used cesarean termination of pregnancy, the treatment group were received spinal-epidural anesthesia, the control group were received continuous epidural anesthesia.ResultsThe treatment group feels block onset time, time to reach the block level T10, T8 time block plane to reach the highest block plane and time are significantly less than the control group （P〈0.05）. The degree of muscle relaxation and stretch the extent of reaction after the treatment group was significantly better than the control group （P〈0.05）. All patients while maintaining perioperative hemodynamic stability, no significant fluctuations in the normal condition.Conclusion Compared with epidural anesthesia, spinal-epidural anesthesia in patients with preeclampsia application had no effect on blood flow dynamics, can play an effective blockade, low muscle relaxation and stretch the extent of reaction that should be widely applied.