妊娠期高血压剖宫产麻醉方式及麻醉效果研究

Study on Anesthesia Methods and Effects of Cesarean Section for Hypertension during Pregnancy

目的探讨妊娠期高血压剖宫产麻醉方式及麻醉效果。方法随机选择该院在2018年1月—2020年10月收治的100例妊娠期高血压剖宫产的产妇进行研究分析,按照随机数表法将产妇分为腰硬联合麻醉组和连续硬膜外麻醉组,各50例,观察两组麻醉效果和安全性。结果腰硬联合麻醉组全部50例产妇麻醉效果佳,麻醉成功率为100%;连续硬膜外麻醉组麻醉成功率为86%,两组比较差异有统计学意义(χ^(2)=5.530,P<0.05)。腰硬联合麻醉组给药10 min、0.5 h和1 h的疼痛评分低于连续硬膜外麻醉组,两组比较差异有统计学意义(t=29.256、25.912、32.084,P<0.05)。腰硬联合麻醉组全部50例产妇子宫下段肌松效果良好,肌松效果差发生率为0%,连续硬膜外麻醉组有7例产妇子宫下段肌松效果差,肌松效果差发生率为14%,两组比较差异有统计学意义(χ^(2)=5.530,P<0.05)。腰硬联合麻醉组麻醉诱导时间、感觉阻滞恢复的时间短于连续硬膜外麻醉组,两组比较差异有统计学意义(t=47.870、238.225,P<0.05)。腰硬联合麻醉组的新生儿窒息发生率为4%,连续硬膜外麻醉组新生儿窒息发生率为4%,两组比较差异无统计学意义(χ^(2)=0.000,P>0.05)。腰硬联合麻醉组寒颤发生率为2%,连续硬膜外麻醉组寒颤发生率为4%,两组比较差异无统计学意义(χ^(2)=0.000,P>0.05)。结论腰硬联合麻醉用于妊娠期高血压剖宫产术麻醉效果确切。

Objective To explore the anesthesia methods and effects of cesarean section for hypertension during pregnancy.Methods 100 pregnant women with hypertensive cesarean section during pregnancy admitted to the hospital from January 2018 to October 2020 were randomly selected for research and analysis.According to the random number table method,the pregnant women were divided into the combined spinal-epidural anesthesia group and the continuous epidural anesthesia group,with 50 cases in each group.Observed the anesthesia effect and safety of the two groups.Results All 50 parturients in the combined spinal-epidural anesthesia group had good anesthesia effects,and the anesthesia success rate was 100%,the success rate of anesthesia in the continuous epidural anesthesia group was 86%,the difference between the two groups was statistically significant(χ^(2)=5.530,P<0.05).The pain scores of the combined spinal-epidural anesthesia group for 10 min,0.5 h and 1 h were lower than those of the continuous epidural anesthesia group,the difference between the two groups was statistically significant(t=29.256,25.912,32.084,P<0.05).In the combined spinal-epidural anesthesia group,all 50 parturients had good muscle relaxation in the lower part of the uterus,and the incidence of poor muscle relaxation was 0%;in the continuous epidural anesthesia group,7 parturients had poor muscle relaxation in the lower segment of the uterus,and the incidence of poor muscle relaxation was 14%,the difference between the two groups was statistically significant(χ^(2)=5.530,P<0.05).The induction time of anesthesia and the recovery time of sensory block in the combined spinal-epidural anesthesia group were shorter than those in the continuous epidural anesthesia group,the difference between the two groups was statistically significant(t=47.870,238.225,P<0.05).The incidence of neonatal asphyxia in the combined spinal-epidural anesthesia group was 4%;the incidence of neonatal asphyxia in the continuous epidural anesthesia group was 4%,the difference between the two groups was not statistically significant(χ^(2)=0.000,P>0.05).The incidence of chills in the combined spinal-epidural anesthesia group was 2%,and the incidence of chills in the continuous epidural anesthesia group was 4%,the difference between the two groups was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion Combined spinal-epidural anesthesia is effective for cesarean section for hypertension during pregnancy.