不同麻醉体位蛛网膜下腔阻滞硬膜外阻滞(腰硬)联合麻醉对剖宫产产妇及其新生儿的影响

Effects of Subarachnoid Block Combined with Epidural Block on Cesarean Section Puerpera and Neonates in Different Anesthesia Positions

目的:观察不同麻醉体位蛛网膜下腔阻滞硬膜外阻滞(腰硬)联合麻醉对剖宫产产妇及其新生儿的影响。方法:本次选取某院2016年1月~2016年12月住院部收治的剖宫产产妇患者88例,将其随机分为两组,观察组44例(采用坐位进行麻醉)和对照组44例(采用左侧卧位进行麻醉),观察两组产妇麻醉后5min的血流动力学指标和新生儿出生后的Apgar评分。结果:观察组的血流动力学指标(收缩压(110.51±10.15)mmHg、舒张压(72.33±8.65)mmHg、心率(95.62±8.23)min/次、平均动脉压(61.63±5.01)mmHg)、新生儿Apgar评分(出生后1min(4~8分4例、8~10分42例)、出生后5min(4~8分1例、8~10分43例))均优于对照组(P<0.05)。结论:剖宫产产妇应用不同麻醉体位蛛网膜下腔阻滞硬膜外阻滞(腰硬)联合麻醉对新生儿无明显影响,但在临床采用坐位进行麻醉有利于产妇顺利进行手术。

Objective：To observe the effect of subarachnoid block combined with epidural block on cesarean section puerpera and neonates in different anesthesia positions.Methods：88 cases of cesarean maternal patients admitted in a hospital from January 2016 to December 2016 were randomly divided into two groups：observation group 44 cases（using anesthesia with sitting position）and control group 44 cases（using anesthesia with left lateral position）.Observed two groups of maternal anesthesia after five minutes of hemodynamic parameters and neonatal apgar score after birth.Results：The hemodynamic parameters of the observation group（systolic blood pressure（110.51±10.15）mmHg,diastolic blood pressure（72.33±8.65）mmHg,heart rate（95.62±8.23）min/time,mean arterial pressure（61.63±5.01）mmHg）,neonatal apgar score （postnatal 1（4-8points in 4cases,8-10cases in 42cases）,5minutes after birth（4-8points in 1case,8-10points in 43cases）were better than the control group（P〈0.05）.Conclusion：The subarachnoid block combined with epidural block has no significant effect on neonates.However,the use of sitting position in the clinic is beneficial to the smooth operation of the mother.