腰麻硬膜外麻醉与硬膜外麻醉在剖宫产中的应用效果比较

Effect Comparison between Combined Spinal Epidural Anesthesia and Epidural Anesthesia in Application of Cesarean Surgery

目的探讨腰麻硬膜外麻醉(combined spinal epidural anesthesia,CSEA)与单纯硬膜外麻醉(epidural anaesthesia,EA)对剖宫产患者麻醉效果及仰卧位低血压综合征(supine hypotensive syndrome,SHS)发生率。方法选择2013年8月—2015年10月行剖宫产的患者159例,根据麻醉方式分为CSEA组和EA组,比较2组麻醉效果、不良反应发生率、新生儿Apgar评分和SHS发生率。结果 CSEA组手术结束时心率、麻醉后收缩压、麻醉后和手术结束时平均动脉压高于EA组(P<0.05)。CSEA组麻醉效果优于EA组(P<0.05)。2组新生儿Apgar评分和不良反应发生率比较差异无统计学意义(P<0.05)。CSEA组SHS发生率低于EA组(P<0.05)。结论 2种麻醉方式安全性均较高,但CSEA的效果优于EA,且SHS发生率较低。

Objective To investigate effect of combined spinal epidural anesthesia（CSEA） and epidural anesthesia （EA） in application of patients with cesarean surgery, and to analyze the incidence rate of supine hypotensive syndrome （SHS）. Methods A total of 159 patients with cesarean section during August 2013 and October 2015 were divided into CSEA group and EA group according to different methods of anesthesia. Anesthesia effect, incidence rate of ad- verse reaction, neonatal Apgar score and the incidence rate of SHS were compared in two groups. Results Values of heart rate （HR） at the end of operation, systolic blood pressure （SBP） after anesthesia and mean arterial blood pressure （MAP） after anesthesia and at the end of operation in CSEA group were significantly higher than those in EA group （P 〈 0.05）. Anesthetic effect in CSEA group was superior than that in EA group （P 〈 0. 05 ）. There were no significant differences in neonatal Apgar score and the incidence rate of adverse reaction between two groups （P 〈 0. 05 ）. Incidence rate of SHS in combined CSEA group was lower than that in EA group （P 〈 0.05）. Conclusion Both CSEA and EA have high safety in application of patients with cesarean surgery, but the CSEA has better effect and lower incidence rate of SHS than those by EA.