全身麻醉与腰麻对剖宫产术产妇和新生儿的影响

Effects of General Anesthesia and Lumbar Anesthesia on Parturients and Newborns Undergoing Cesarean Section

目的:比较分析全身麻醉与腰麻对剖宫产术产妇和新生儿的影响。方法:选择2018年1月~2018年12月在我院进行剖宫产术的81例产妇,随机分为两组。对照组的40例产妇在剖宫产术中采用腰麻,观察组的41例产妇在剖宫产术中采用全身麻醉。记录两组的切皮至娩出时间、手术时间和新生儿体质量;比较两组新生儿的Apgar评分、动脉血气分析检测值和神经行为评分;并比较两组产妇的平均动脉压以及心率。结果:两组的切皮至娩出时间、手术时间和新生儿体质量没有明显的差异(P>0.05);两组胎儿娩出之后1 min和5 min的Apgar评分没有明显的差异(P>0.05);两组新生儿出生后30 min的二氧化碳分压、pH值、氧分压、红细胞压积以及血氧饱和度没有明显的差异(P>0.05);两组新生儿出生后1 d、3 d和5 d的神经行为评分没有明显的差异(P>0.05);与麻醉前相比,两组产妇切皮时和取出胎儿时的平均动脉压以及心率均明显降低(P<0.05),且观察组产妇切皮时和取出胎儿时的平均动脉压以及心率均明显高于对照组(P<0.05)。结论:全身麻醉和腰麻都适用于剖宫产手术,全身麻醉不仅可以维持剖宫产产妇血流动力学稳定,而且对新生儿Apgar评分、动脉血气分析和神经行为评分无明显的影响,具有较高的临床价值。

Objective: To study the effects of general anesthesia and lumbar anesthesia on Parturients and newborns undergoing cesarean section. Methods: Selected 81 cases of parturients undergoing cesarean section who were treated in our hospital from January2018 to December 2018, divided into two groups randomly. 40 cases in the control group were given lumbar anesthesia during cesarean section, and 41 cases in the observation group were given general anesthesia during cesarean section. The time from skin incision to delivery, operation time and neonatal body mass were recorded;the Apgar score, arterial blood gas analysis and neurobehavioral score at different time after birth were compared between the two groups;and the average arterial pressure and heart rate before anesthesia, during skin incision and fetal removal were compared between the two groups. Results: There was no significant difference in the time from skin incision to delivery, operation time and neonatal body mass between the two groups(P>0.05). There was no significant difference in partial pressure of carbon dioxide, pH value, partial pressure of oxygen, hematocrit and oxygen saturation in group A and group B 30 minutes after birth(P>0.05), and no significant difference in neurobehavioral score between two groups at 1, 3 and 5 days after birth(P>0.05).Compared with before anesthesia, the mean arterial pressure and heart rate of the two groups were significantly lower(P<0.05), and the mean arterial pressure and heart rate of the observation group were significantly higher than those of the control group(P<0.05). Conclusion: General anesthesia and lumbar anesthesia are both suitable for cesarean section. General anesthesia can not only maintain the hemodynamic stability of cesarean section women, but also have no significant impact on Apgar score, arterial blood gas analysis and neurobehavioral score of newborns. It has high clinical value.