甘孜州高原地区重度妊高症剖宫产麻醉的临床分析

Clinical analysis of cesarean section anesthesia in patients with severe pregnancy-induced hypertension syndrome in plateau area of Ganzi Tibetan Autonomous Prefecture

目的探讨甘孜州高原地区重度妊高症患者行剖宫产术的围麻醉期处理及其对母婴的影响。方法回顾分析甘孜州高海拔地区120例重度妊高症剖宫产患者病例资料。结果 120例剖宫产麻醉中,76例患者采用了,44例采用了全身麻醉。两组患者术前血红蛋白、平均动脉血压差异无统计学意义(P>0.05),全身麻醉组患者的血小板数、凝血酶原时间、部分凝血活酶时间明显低于腰硬联合麻醉组(P<0.05);两组术中母婴情况、术后产妇住院时间差异均无统计学意义(P>0.05)。结论充分的术前准备,合适的麻醉选择,术中加强监测与调控及术中液体管理,腰硬联合麻醉及全身麻醉对术后母婴的影响相似。

Objective To investigate the anesthesia management for the patients with severe pregnancy-induced hypertension syndrome （PIH） in plateau area and its influence on maternal and neonatal outcome. Methods The data of 120 cases with severe PIH receiving cesarean section from January 2012 to December 2015 were retrospectively analyzed. Results Of the 120 patients ,76 patients received combined spinal-epidural anesthesia （CSEA） mad 44 patients received general anesthesia （GA）. There were no significant differences in hemoglobin （Hb） and mean arterial pressure （MAP） before operation between the two groups （P 〉0. 05 ）. However,. platelets （PT）, activated partial thromboplastin time （APTT） and prothrombin time （PLT） in the group GA was significantly lower than those in the group CSEA （ P 〈0. 05 ）. There was no significant difference in effect of anesthesia methods on parturient and neonate between the two group （ P 〉0. 05 ）. Conclusion Full preoperative preparation, optimal section of anesthesia, strengthening intraoperarive monitoring, and intraoperative fluid administration are important measures to prevent and treat the severe complications on parturient and neonate.