腰-硬联合麻醉与硬膜外腔麻醉用于剖宫产术效果及对新生儿的影响

Combined spinal-epidural anesthesia and epidural anesthesia on cesarean section and newborns

目的观察腰-硬联合麻醉(SCEA)与连续硬膜外腔麻醉(CEA)用于剖宫产术临床效果及对新生儿Apgar评分的影响。方法选择我院行剖宫产术产妇900例,依据麻醉方式不同分为CEA组与SCEA组各450例,对比2组麻醉效果、麻醉诱导至胎儿娩出时间(I-D)、子宫切开至胎儿娩出时间(U-D)、手术时间及新生儿娩出后1、5、10 min Apgar评分。结果 SCEA组麻醉1级率显著高于CEA组(P<0.05);CEA组的手术时间、I-D、U-D时间均高于SCEA组(P<0.05)。CEA组胎儿出生后1、5、10 min新生儿Apgar评分均低于SCEA组(P<0.05)。结论 SCEA用于剖宫产术具有起效快、麻醉效果完善、肌松满意的特点,由于I-D时间的缩短,可显著降低新生儿宫内窘迫、缺氧、窒息等并发症的发生率,有利于母婴预后。

Objective To observe the clinical efficacy of combined spinal-epidural anesthesia（ CSEA） and continuous epidural anesthesia（ CEA） in application of cesarean section and the effect on Apgar scores in newborns. Methods A total f 900 pregnant women were divided into CSEA group and CEA group according to different anesthesia methods with 450 cases in each group. The anesthetic effect,I-D,U-D,operation time,Apgar scores 1,5,10 min after delivery in the two groups were compared. Results Level 1 rate of anesthesia in CSEA group was significantly higher than that in CEA group（ P〈0. 05）. The operation time,I-D,and U-D in CEA group were significantly higher than those in CSEA group（ P〈0. 05）. Apgar 1,5,10 min after delivery in CEA group were significantly lower than those in CSEA group（ P〈0. 05）. Conclusion CSEA in application of cesarean section is characterized by rapid effect taking,perfect anesthetic effect,and satisfying muscular relaxation,and can significantly reduce the occurrence rate of complications of intrauterine distress,hypoxia,and asphyxia,which is beneficial for the prognosis of mother and child.