麻醉处理在重度妊娠高血压综合征行剖宫产术的效果观察

Anesthesia treatment in cesarean section of severe pregnancy-induced hypertension syndrome

目的探讨重度妊娠高血压综合征行剖宫产术的麻醉处理效果。方法选取2014年7月至2015年8月行剖宫产术的重度妊娠高血压综合征患者56例,49例无椎管内麻醉禁忌证者首选连续硬膜外阻滞,7例有禁忌证者行全身麻醉,分析所有患者的麻醉效果和妊娠结局。结果 56例患者均顺利完成麻醉手术的过程,术中7例硬膜外麻醉患者收缩压下降至100 mm Hg（1 mm Hg=0.133 k Pa）,13例患者有牵扯痛。全身麻醉患者术毕清醒,无烦躁或抽搐症状。术毕50例产妇送回病房,6例送ICU综合治疗。56例新生儿娩出后1 min的评分情况为：10分32例,7~9分19例,〈5分5例。经处理,新生儿娩出后5 min的评分全部达到10分。术后半个月患者均安全出院。结论有效的麻醉处理方式是重症妊娠高血压综合征患者行剖宫产手术顺利进行的重要保证,麻醉医生应根据患者的情况选择恰当的麻醉处理方式,麻醉中应维持血流动力学稳定和充足的有效供氧,缓解患者的紧张情绪,保障母婴安全。

Objective To study the anethesia effect in cesarean section of severe pregnancy-induced hypertension syndrome.Methods From July 2012 to August 2015,56 patients underwent cesarean section surgery with severe pregnancy-induced hypertension syndrome were selected,49 patients without contraindications were given continuous epidaral anesthesia as first choice and 7 cases with contraindications were given general anesthesia. The anesthesia effects of all patients,and pregnancy outcomes were analyzed. Results All 56 patients had successfully completed the process of anesthesia,the systolic blood pressure decreased to 100 mm Hg（ 1 mm Hg = 0. 133 k Pa） in 7 patients with epidural anesthesia during operation,13 patients had pain involved. The patients regain conscious at the end of the operation in patients with general anesthesia,no symptom of irritability or convulsion. After operation,50 cases were sent back to the ward,6 cases were sent to ICU. The 1 minute score of 56 neonate：32 cases of 10,19 cases of 7 to 9,5 cases of less than 5. After processing,the scores all reached 10 points at 5 min after delivery. Safely discharged half a month after surgery. Conclusion Effective anesthetic is the guarantee of the successfull cesarean operation of severe pregnancy-induced hypertension syndrome,the anesthesiologist should dealt with according to patients proper anesthesia. Effective anesthesia should maintain stable and adequate oxygen supply,relieve tension and safeguard maternal and child safety.