目的:探究间羟胺联合腰硬联合麻醉对剖宫产产妇的影响。方法:选取2021年1月—2022年10月泉州市第一医院收治的100例待剖宫产产妇。根据随机数表法将其分为腰硬联合麻醉组和联合治疗组,各50例。腰硬联合麻醉组给予腰硬联合麻醉,联合治疗...目的:探究间羟胺联合腰硬联合麻醉对剖宫产产妇的影响。方法:选取2021年1月—2022年10月泉州市第一医院收治的100例待剖宫产产妇。根据随机数表法将其分为腰硬联合麻醉组和联合治疗组,各50例。腰硬联合麻醉组给予腰硬联合麻醉,联合治疗组给予间羟胺联合腰硬联合麻醉。比较两组麻醉前、术后收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)、心率(HR)、心脏指数(CI),手术指标,新生儿缺氧情况及不良反应。结果:术后,两组DBP、SBP、MAP下降,但联合治疗组DBP、SBP、MAP均高于腰硬联合麻醉组,差异有统计学意义(P<0.05)。术后,两组HR、CO、CI均降低,但联合治疗组HR、CO、CI均高于腰硬联合麻醉组,差异有统计学意义(P<0.05)。两组手术时间、术中失血量、术中液体输注量比较,差异无统计学意义(P>0.05)。两组新生儿1 min和5 min Apgar评分比较,差异无统计学意义(P>0.05)。联合治疗组不良反应发生率低于腰硬联合麻醉组,差异有统计学意义(P<0.05)。结论:间羟胺联合腰硬联合麻醉对剖宫产产妇进行干预,能较好地维护产妇血压、心率水平,调节产妇血流动力学,对新生儿Apgar评分有较小的影响,效果显著。展开更多
目的:探讨无创皮肤吻合器联合心形缝合皮下脂肪对腹部瘢痕的影响。方法:回顾性分析2021年1月—2022年9月于新余市妇幼保健院行剖宫产手术的120例患者的病历资料,将接受无创皮肤吻合器联合心形缝合的60例患者纳入A组,将接受无创皮肤吻合...目的:探讨无创皮肤吻合器联合心形缝合皮下脂肪对腹部瘢痕的影响。方法:回顾性分析2021年1月—2022年9月于新余市妇幼保健院行剖宫产手术的120例患者的病历资料,将接受无创皮肤吻合器联合心形缝合的60例患者纳入A组,将接受无创皮肤吻合器联合传统美容缝合的60例患者纳入B组,两组出院后均随访6个月。比较两组切口缝合时间、切口愈合时间及住院时间,术后24 h、72 h、7 d切口疼痛[视觉模拟评分法(VAS)],术后1个月切口愈合情况、切口并发症发生率,术后6个月切口瘢痕情况[温哥华瘢痕评定量表(VSS)]、缝合效果满意度。结果:两组切口缝合时间差异无统计学意义(P>0.05),A组切口愈合时间与住院时间均短于B组,差异均有统计学意义(P<0.05);两组术后24 h、72 h VAS评分差异均无统计学意义(P>0.05),A组术后7 d VAS评分低于B组,差异有统计学意义(P<0.05);术后1个月,A组伤口愈合等级优于B组,A组切口并发症总发生率低于B组,差异均有统计学意义(P<0.05);术后6个月,A组VSS评分低于B组,A组缝合效果满意度高于B组,差异均有统计学意义(P<0.05)。结论:无创皮肤吻合器联合心形缝合皮下脂肪在剖宫产患者中应用价值高,能有效促进术后患者腹部切口愈合,减少术后疼痛,降低切口并发症发生及瘢痕增生风险,并获得更高的患者满意度。展开更多
目的:比较罗哌卡因与布比卡因腰硬联合麻醉在剖宫产产妇中的应用效果。方法:选取2020年1月至2022年12月该院收治的80例剖宫产产妇进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各40例。对照组行布比卡因腰硬联合麻醉,观察组...目的:比较罗哌卡因与布比卡因腰硬联合麻醉在剖宫产产妇中的应用效果。方法:选取2020年1月至2022年12月该院收治的80例剖宫产产妇进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各40例。对照组行布比卡因腰硬联合麻醉,观察组行罗哌卡因腰硬联合麻醉,比较两组感觉阻滞起效时间、运动阻滞起效时间、新生儿出生1 min Apgar评分、平均动脉压、心率和不良反应发生率。结果:观察组产妇感觉阻滞、运动阻滞起效时间均长于对照组,差异有统计学意义(P<0.05);切皮即刻、胎儿娩出时,观察组平均动脉压、心率高于对照组,差异均有统计学意义(P<0.05);观察组不良反应发生率为7.50%,明显低于对照组的25.00%,差异有统计学意义(P<0.05);两组新生儿出生1 min Apgar评分比较,差异无统计学意义(P>0.05)。结论:罗哌卡因腰硬联合麻醉用于剖宫产产妇中可提高产妇术中平均动脉压、心率,降低不良反应发生率,效果优于布比卡因腰硬联合麻醉,但会延长感觉阻滞、运动阻滞起效时间。展开更多
BACKGROUND Thrombotic pulmonary embolism(TPE)is one of the most critical diseases in obstetrics but is rarely reported in caesarean section(CS)because TPE patients in CS have a high risk of death and are difficult to ...BACKGROUND Thrombotic pulmonary embolism(TPE)is one of the most critical diseases in obstetrics but is rarely reported in caesarean section(CS)because TPE patients in CS have a high risk of death and are difficult to diagnose.This case report of TPE during CS was recorded by transthoracic echocardiography(TTE)and can provide a reference for the differential diagnosis of critical illnesses in CS.CASE SUMMARY A 37-year-old pregnant woman with rheumatic heart disease(RHD),gravida 5 and para 1(G5P1),presented for emergency CS at 33 wk and 3 d of gestation under general anesthesia because of acute heart failure,pulmonary hypertension and arrhythmia.After placental removal during CS,TTE revealed a nascent thrombus in the inferior vena cava(IVC)that elongated,detached and fragmented leading to acute thromboembolic events and acute TPE.This report presents the whole process and details of TPE during CS and successful rescue without any sequelae in the patient.This case gives us new ideas for the diagnosis of death or cardiovascular accidents during CS in pregnant women with heart disease and the detailed presentation of the rapid development of TPE may also elucidate new ideas for treatment.This case also highlighted the importance of prophylactic anticoagulation in the management of heart disease during pregnancy.CONCLUSION Pregnancy with heart failure could trigger inferior vena cava(IVC)-origin TPE during CS.Detection and timely treatment can avoid serious consequences.展开更多
Heart disease in pregnancy is the cause of significant maternal and perinatal morbidity. We wanted to evaluate the maternal and perinatal outcomes </span><a name="_Hlk89187857"></a><span...Heart disease in pregnancy is the cause of significant maternal and perinatal morbidity. We wanted to evaluate the maternal and perinatal outcomes </span><a name="_Hlk89187857"></a><span style="font-family:Verdana;">of pregnant women with heart disease in Yaoundé, Cameroon. This was a cross sectional study with retrospective data collection of 45 pregnancies in 42 women with heart disease followed at three Yaoundé referral hospitals in Yaoundé, Cameroon from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2015 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. We collected data on maternal obstetrical and perinatal outcomes. The frequency of pregnancies with heart diseases was 0.1%. The mean maternal age was 29.05 ± 6.5 years. At first antenatal visit, all patients were in class I (84.4%) and II (15.6%) of the New-York Heart Association (NYHA) functional class. Valvular heart disease (51.1%) was the most common type followed by cardiomyopathy (37.7%). Over half of the deliveries were vaginal (51.1%). A cesarean section was generally indicated for the usual obstetrical reasons (54.5%) and for heart disease (31.8%). Complications included 17 (37.7%) cases of heart failure, 6 (13.3%) cases of pulmonary edema, 2 (04.4%) cases of pulmonary </span><span style="font-family:Verdana;">embolism, 3 (06.6%) maternal deaths and 3 (06.3%) perinatal deaths, 14 (29.7%)</span><span style="font-family:Verdana;"> premature births and 3 cases of (6.3%) intrauterine growth retardation. The maternal deaths were cases complicated by pulmonary edema and all had di</span><span style="font-family:Verdana;">lated cardiomyopathy. The maternal and perinatal outcomes of pregnant women with heart disease </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> marked in our environment by increased</span><span style="font-family:Verdana;"> morbidity and mortality. Therefore, it is necessary to improve the prenatal, per partum and postpartum management of this high-risk group.展开更多
文摘目的:探究间羟胺联合腰硬联合麻醉对剖宫产产妇的影响。方法:选取2021年1月—2022年10月泉州市第一医院收治的100例待剖宫产产妇。根据随机数表法将其分为腰硬联合麻醉组和联合治疗组,各50例。腰硬联合麻醉组给予腰硬联合麻醉,联合治疗组给予间羟胺联合腰硬联合麻醉。比较两组麻醉前、术后收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)、心率(HR)、心脏指数(CI),手术指标,新生儿缺氧情况及不良反应。结果:术后,两组DBP、SBP、MAP下降,但联合治疗组DBP、SBP、MAP均高于腰硬联合麻醉组,差异有统计学意义(P<0.05)。术后,两组HR、CO、CI均降低,但联合治疗组HR、CO、CI均高于腰硬联合麻醉组,差异有统计学意义(P<0.05)。两组手术时间、术中失血量、术中液体输注量比较,差异无统计学意义(P>0.05)。两组新生儿1 min和5 min Apgar评分比较,差异无统计学意义(P>0.05)。联合治疗组不良反应发生率低于腰硬联合麻醉组,差异有统计学意义(P<0.05)。结论:间羟胺联合腰硬联合麻醉对剖宫产产妇进行干预,能较好地维护产妇血压、心率水平,调节产妇血流动力学,对新生儿Apgar评分有较小的影响,效果显著。
文摘目的:探讨无创皮肤吻合器联合心形缝合皮下脂肪对腹部瘢痕的影响。方法:回顾性分析2021年1月—2022年9月于新余市妇幼保健院行剖宫产手术的120例患者的病历资料,将接受无创皮肤吻合器联合心形缝合的60例患者纳入A组,将接受无创皮肤吻合器联合传统美容缝合的60例患者纳入B组,两组出院后均随访6个月。比较两组切口缝合时间、切口愈合时间及住院时间,术后24 h、72 h、7 d切口疼痛[视觉模拟评分法(VAS)],术后1个月切口愈合情况、切口并发症发生率,术后6个月切口瘢痕情况[温哥华瘢痕评定量表(VSS)]、缝合效果满意度。结果:两组切口缝合时间差异无统计学意义(P>0.05),A组切口愈合时间与住院时间均短于B组,差异均有统计学意义(P<0.05);两组术后24 h、72 h VAS评分差异均无统计学意义(P>0.05),A组术后7 d VAS评分低于B组,差异有统计学意义(P<0.05);术后1个月,A组伤口愈合等级优于B组,A组切口并发症总发生率低于B组,差异均有统计学意义(P<0.05);术后6个月,A组VSS评分低于B组,A组缝合效果满意度高于B组,差异均有统计学意义(P<0.05)。结论:无创皮肤吻合器联合心形缝合皮下脂肪在剖宫产患者中应用价值高,能有效促进术后患者腹部切口愈合,减少术后疼痛,降低切口并发症发生及瘢痕增生风险,并获得更高的患者满意度。
文摘目的:比较罗哌卡因与布比卡因腰硬联合麻醉在剖宫产产妇中的应用效果。方法:选取2020年1月至2022年12月该院收治的80例剖宫产产妇进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各40例。对照组行布比卡因腰硬联合麻醉,观察组行罗哌卡因腰硬联合麻醉,比较两组感觉阻滞起效时间、运动阻滞起效时间、新生儿出生1 min Apgar评分、平均动脉压、心率和不良反应发生率。结果:观察组产妇感觉阻滞、运动阻滞起效时间均长于对照组,差异有统计学意义(P<0.05);切皮即刻、胎儿娩出时,观察组平均动脉压、心率高于对照组,差异均有统计学意义(P<0.05);观察组不良反应发生率为7.50%,明显低于对照组的25.00%,差异有统计学意义(P<0.05);两组新生儿出生1 min Apgar评分比较,差异无统计学意义(P>0.05)。结论:罗哌卡因腰硬联合麻醉用于剖宫产产妇中可提高产妇术中平均动脉压、心率,降低不良反应发生率,效果优于布比卡因腰硬联合麻醉,但会延长感觉阻滞、运动阻滞起效时间。
基金Supported by the National Natural Science Foundation of China,No.81870320the Health Science and Technology Project of Guangzhou,No.20191A011086.
文摘BACKGROUND Thrombotic pulmonary embolism(TPE)is one of the most critical diseases in obstetrics but is rarely reported in caesarean section(CS)because TPE patients in CS have a high risk of death and are difficult to diagnose.This case report of TPE during CS was recorded by transthoracic echocardiography(TTE)and can provide a reference for the differential diagnosis of critical illnesses in CS.CASE SUMMARY A 37-year-old pregnant woman with rheumatic heart disease(RHD),gravida 5 and para 1(G5P1),presented for emergency CS at 33 wk and 3 d of gestation under general anesthesia because of acute heart failure,pulmonary hypertension and arrhythmia.After placental removal during CS,TTE revealed a nascent thrombus in the inferior vena cava(IVC)that elongated,detached and fragmented leading to acute thromboembolic events and acute TPE.This report presents the whole process and details of TPE during CS and successful rescue without any sequelae in the patient.This case gives us new ideas for the diagnosis of death or cardiovascular accidents during CS in pregnant women with heart disease and the detailed presentation of the rapid development of TPE may also elucidate new ideas for treatment.This case also highlighted the importance of prophylactic anticoagulation in the management of heart disease during pregnancy.CONCLUSION Pregnancy with heart failure could trigger inferior vena cava(IVC)-origin TPE during CS.Detection and timely treatment can avoid serious consequences.
文摘Heart disease in pregnancy is the cause of significant maternal and perinatal morbidity. We wanted to evaluate the maternal and perinatal outcomes </span><a name="_Hlk89187857"></a><span style="font-family:Verdana;">of pregnant women with heart disease in Yaoundé, Cameroon. This was a cross sectional study with retrospective data collection of 45 pregnancies in 42 women with heart disease followed at three Yaoundé referral hospitals in Yaoundé, Cameroon from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2015 to December 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. We collected data on maternal obstetrical and perinatal outcomes. The frequency of pregnancies with heart diseases was 0.1%. The mean maternal age was 29.05 ± 6.5 years. At first antenatal visit, all patients were in class I (84.4%) and II (15.6%) of the New-York Heart Association (NYHA) functional class. Valvular heart disease (51.1%) was the most common type followed by cardiomyopathy (37.7%). Over half of the deliveries were vaginal (51.1%). A cesarean section was generally indicated for the usual obstetrical reasons (54.5%) and for heart disease (31.8%). Complications included 17 (37.7%) cases of heart failure, 6 (13.3%) cases of pulmonary edema, 2 (04.4%) cases of pulmonary </span><span style="font-family:Verdana;">embolism, 3 (06.6%) maternal deaths and 3 (06.3%) perinatal deaths, 14 (29.7%)</span><span style="font-family:Verdana;"> premature births and 3 cases of (6.3%) intrauterine growth retardation. The maternal deaths were cases complicated by pulmonary edema and all had di</span><span style="font-family:Verdana;">lated cardiomyopathy. The maternal and perinatal outcomes of pregnant women with heart disease </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> marked in our environment by increased</span><span style="font-family:Verdana;"> morbidity and mortality. Therefore, it is necessary to improve the prenatal, per partum and postpartum management of this high-risk group.
