左侧斜卧位在腰硬联合麻醉下剖宫产术中对产妇血流动力学的临床应用效果

Clinical Application Effect of Left Oblique Lying Position in Cesarean Section Under Combined Spinal Epidural Anesthesia on Maternal Hemodynamics

目的探讨左侧斜卧位在腰硬联合麻醉下剖宫产术中对产妇血流动力学的临床应用效果。方法整群选取该院在2015年5—10月收治的62例行剖宫产患者分为A、B两组,每组31例,在手术前对两组患者行麻醉,再协助A组患者左侧倾斜15-20°位,B组协助患者平卧位。手术结束时记录产妇的SBP、HR,观察两组患者的不良症状及血流动力学指标。结果 A、B两组在用药前SBP均偏高,在分别给予10 min用药后A组SBP为120.47 mm Hg左右,B组为115.57mm Hg左右;A组HR为83.2次/min左右,B组为93.8次/min左右,两组产妇均在血压水平正常范围内,但A组SPB高于B组,HR低于B组,两组比较差异有统计学意义（P〈0.05）。结论左侧斜卧位腰硬联合麻醉下剖宫术对产妇血流动力学的影响较小,可降低低血压的发生率,麻醉安全性可靠,值得临床推广应用。

Objective To observe the effect of the clinical application of the left oblique lying position in the blood flow dynamics during cesarean section under combined spinal epidural anesthesia. Methods Group selection in our hospital in2015 from May to October were 62 cases of cesarean section were divided into two groups： group A and group B, 31 cases in each group, before the operation of the two groups of patients underwent anesthesia, to help a group of patients with left tilt 15 to 20 degrees a, B group to assist the patient supine. At the end of operation were recorded in SBP, HR, observe the adverse symptoms and hemodynamics of patients in two groups. Results A, B two groups before treatment SBP was higher,were given 10 min drug a group SBP is about 120.47 mm Hg, group B is about 115.57 mm Hg; a group of HR for 83.2 times /min or so, HR in group B is about 93.8 times / min, the women in the two groups were within the normal range of blood pressure levels, but a group of SPB higher than group B, HR below B group, two groups have statistical significance（P〈0.05）.Conclusion The left recumbent combined spinal epidural anesthesia for cesarean section has little effect on maternal hemodynamics, can reduce the incidence of hypotension, anesthesia is safe and reliable, worthy of clinical application.