硬膜外麻醉联合腰麻及心理干预对剖宫产产妇患者心理状态及术后认知功能的影响

Effects of epidural anesthesia combined with spinal anesthesia and psychological intervention on psychological state and postoperative cognitive function of pregnant women undergoing cesarean section

目的探讨剖宫产产妇使用硬膜外麻醉联合腰麻及心理干预对患者心理状态及术后认知功能的影响。方法纳入100例剖宫产产妇(2020年1月~2020年12月),按双盲法分为对照组(n=50,采用硬膜外麻醉联合腰麻)和观察组(n=50,采用硬膜外麻醉联合腰麻及心理干预),统计两组心理状态、麻醉效果、不良事件发生率、生命体征、认知功能。结果(1)心理状态:麻醉后观察组抑郁自评量表(Self-rating depression scale,SDS)评分、焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分低于对照组(P<0.05)。(2)麻醉效果:观察组麻醉起效时间、达最高阻滞平面时间、运动阻滞恢复时间低于对照组,镇痛维持时间高于对照组(P<0.05)。(3)不良事件发生率:观察组(6.00%)低于对照组(20.00%)(P<0.05)。(4)生命体征:观察组T1、T2、T3时间段平均动脉压(mean arterial pressure,MAP)低于对照组,心率(heartbeat,HR)高于对照组(P<0.05)。(5)认知功能:观察组高于对照组(P<0.05)。结论硬膜外麻醉联合腰麻及心理干预在剖宫产产妇麻醉中效果确切,可提高麻醉效果,亦可维持机体生命体征稳定,降低低体温、寒战等不良事件发生率,促进患者认知功能恢复,值得借鉴及参考。

Objective To explore the effects of epidural anesthesia combined with spinal anesthesia and psychological intervention on the psychological state and postoperative cognitive function of pregnant women undergoing cesarean section.Methods 100 cases of cesarean section were included in the study(January 2020~December 2020).They were divided into control group(n=50,epidural anesthesia combined with spinal anesthesia)and observation group(n=50,using epidural anesthesia combined with spinal anesthesia and psychological intervention).The psychological state,anesthetic effect,incidence of adverse events,vital signs and cognitive function of the two groups were counted.Results(1)psychological status:the scores of self rating Depression Scale(SDS)and self rating Anxiety Scale(SAS)in the observation group after anesthesia were lower than those in the control group(P<0.05).(2)Anesthesia effect:the onset time of anesthesia,the time to reach the highest block plane and the recovery time of motor block in the observation group were lower than those in the control group,and the maintenance time of analgesia was higher than that in the control group(P<0.05).(3)The incidence of adverse events in the observation group(6.00%)was lower than that in the control group(20.00%)(P<0.05).(4)Vital signs:the mean arterial pressure(map)in the observation group at T1,T2 and T3 was lower than that in the control group,and the heart rate(HR)was higher than that in the control group(P<0.05).(5)Cognitive function:the observation group was higher than the control group(P<0.05).Conclusion The effect of epidural anesthesia combined with spinal anesthesia and psychological intervention in cesarean section is accurate,which can improve the anesthetic effect,maintain the stability of vital signs,reduce the incidence of adverse events such as hypothermia and shivering,and promote the recovery of cognitive function,which is worthy of reference.