妊娠重度高血压疾病患者剖宫产麻醉分析

Analysis of Cesarean Section Anesthesia of Patients with Severe Hypertension Disease Combined with Pregnancy

目的分析妊娠重度高血压患者剖宫产的麻醉处理措施。方法选取2016年11月—2017年11月之间收治的妊娠重度高血压疾病患者90例作为研究对象,随机分为观察组和对照组,每组患者45例,对照组患者接受硬膜外麻醉,观察组患者接受腰-硬联合麻醉,比较两组患者的临床麻醉效果。结果观察组患者麻醉效果优于对照组[达最高麻醉平面时间(12.5±3.7)vs(25.2±6.4)min,运动阻滞恢复时间(110.0±15.0)vs(182.9±18.0)min,感觉阻滞恢复时间(150.5±16.5)vs(218.0±20.5)min],差异有统计学意义(P<0.05),观察组出现不适或疼痛感的发生率及肌松满意、寒战的发生率显著低于对照组,差异有统计学意义[0.0%vs24.2%,37.8vs82.2%,11.1vs40.0%](P<0.05),观察组与对照组在低血压、心动过缓方面比较差异无统计学意义(P>0.05),观察组患者麻醉诱导时间显著低于对照组[(6.0±1.1)vs(19.1±1.6)min](P<0.05),而新生儿娩出时间及1 min阿氏评分与对照组相比差异无统计学意义(P>0.05)。结论对妊娠重度高血压疾病患者实行腰-硬联合麻醉效果与硬膜外麻醉效果相比更加良好,缩短患者的运动阻滞、感觉阻滞的恢复时间,减轻患者疼痛,具有较高的临床应用推广价值。

Objective To analyze the treatment measures of cesarean section anesthesia of patients with severe hypertension disease combined with pregnancy. Methods 90 cases of patients with severe hypertension disease combined with pregnancy admitted and treated in our hospital from November 2016 to November 2017 were selected and randomly divided into two groups with 45 cases in each, the control group and the observation group respectively used the epidural anesthesia and combined spinal-epidural anesthesia, and the clinical anesthesia effect was compared between the two groups. Results The anesthesia effect in the observation group was better than that in the control group,（the highest anesthesia plane time（12.5±3.7）vs（25.2±6.4）min, motor blocking recovery time（110.0±15.0）vs（182.9±18.0）min,sensory block recovery time（150.5±16.5）vs（218.0±20.5）min）], and the differences were obvious, with statistical significance（P〈0.05）, and the incidence rates of discomfort or pains and metaxalone satisfaction and chill in the observation group were obviously lower than those in the control group, and the differences were statistically significant [0.0%vs24.2%,37.8 vs82.2%,11.1 vs40.0%]（P〈0.05）, and the differences in the hypotension and bradycardia between the two groups were not obvious, without statistical significance（P〈0.05）, and the anesthesia induced time in the observation group was obviously lower than that in the control group [（6.0±1.1）vs（19.1±1.6）min]（P〈0.05）, and the differences in the delivery time of newborns and 1-min Apgar scores between the two groups were not obvious, without statistical significance（P〈0.05）. Conclusion The effect of cmbined spinal-epidural anesthesia in patients with severe hypertension disease combined with pregnancy is better than that of eidural anesthesia, which can shorten the recovery time of motor block and sensory block and relieve the pains of patients, with higher clinical application and promotion value.