Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment

Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion.

Pneumocephalus Following Combined Spinal-Epidural Anesthesia: A Case Report Analysis

Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.

Effect of combined spinal and epidural anesthesia on the level of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section

Objective: To discuss the effect of combined spinal and epidural anesthesia on the levels of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section. Methods: Eighty patients who underwent cesarean section in our hospital from January 2017 to April 2019 were enrolled in the hospital. They were divided into two groups according to the patient's anesthesia. Fourty patients receiving epidural anesthesia were included in the control group, and another 40 patients received lumbar stiffness. The combined anesthesia patient was included in the observation group. Changes in pain mediators [Serum neuropeptide Y (NPY), endorphin (β-EP), substance P (SP)], stress indicators [Serum cortisol (Cor), C-peptide (C-P), advanced oxidative protein product (AOPP)], inflammatory factor levels [Hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α)], and immunoglobulin levels [Serum IgA, IgG, IgM] were compared between the two groups. Results: Before anesthesia, there were no significant difference in pain media, stress index, inflammatory factor level and immunoglobulin level between the two groups (P>0.05). At 12 h after operation, the two groups of patients were NPY, β-EP, SP, Cor. The levels of C-P, AOPP, hs-CRP and TNF-α were higher than those before operation (P<0.05). The levels of IgA, IgG and IgM were lower than those before operation (P<0.05). Among them, observation group NPY, β-EP, SP, Cor, C-P, AOPP, hs-CRP and TNF-α were significantly lower than those of the control group (P<0.05). The serum levels of IgA, IgG and IgM were significantly higher than those of the control group (P<0.05). Conclusion: Combined spinal and epidural anesthesia can more effectively alleviate maternal pain in high altitude cesarean section, more effectively reduce the inflammatory stress response of patients, promote the humoral immune function of patients, and is beneficial to the early recovery of maternal postoperative, and has high clinical value.

Effects of Combined Spinal Epidural Anaesthesia and Spinal Anaesthesia on Peri-Operative Pulmonary Status in Geriatric Patients in Lower Extremity Surgery

Background: Lower extremity surgeries performed in elderly people usually have high prevalence of peri-operative medical problems related to anaesthesia. The overall objective of peri-operative care of geriatric population is to fast recovery from anaesthesia and avoid functional decline. Objective: To compare the peri-operative pulmonary status of combined spinal epidural anaesthesia (CSEA) and spinal anaesthesia (SA) in geriatric patients underwent lower extremity surgeries. Methods: This prospective comparative study was conducted at Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2016 to June 2018. A total of 70 geriatric cases that underwent lower extremity surgeries were included in this study. Cases were randomly allocated into two groups;35 in Group A (CSEA) and 35 in Group B (SAB). The different outcome variables between the groups like-duration of anaesthesia, respiratory rates (RR), oxygen saturation (SpO2), end tidal CO2 (EtCO2), peak expiratory flow rate (PEFR), breath holding test (BHT), peri-operative side effects of anaesthesia and post-operative visual analogue score (VAS) were analyzed and compared by statistical tests. Results: The mean age, weight, BMI of Group A and Group B patients were not significantly different (p > 0.05). No significant differences were observed in duration of surgery, gender and ASA grade between the groups (p > 0.05). Mean duration of anaesthesia, mean time to achieve target level of sensory block and mean time to achieve complete motor block were significantly higher in Group A (p < 0.001). Mean RR, SpO2, EtCO2, PEFR and BHT of both groups were not significantly different (p > 0.05). Peri-operative side effects of anaesthesia and post-operative VAS were significantly less in group A patients (p < 0.05). Conclusion: Combined spinal epidural anaesthesia is effective and safe;produces stable peri-operative pulmonary status with prolonging analgesia and fewer side effects as compared to spinal anaesthesia in geriatric patients.

CSEA用于肾移植麻醉的研究

为探讨脊麻硬膜外联合阻滞（ＣＥＳＡ） 在同种异体肾移植手术中的效果，对２２ 例同种异体肾移植手术病人，使用脊麻硬膜外联合阻滞（Ａ 组） ，并与２２ 例连续硬膜外阻滞（Ｂ 组） 进行比较。结果：Ａ 组麻醉起效快〔Ｔ８ 阻滞时间（２ ．９ ±１ ．１） ｍｉｎ〕，与Ｂ 组〔（９ ．０ ±１ ．９） ｍｉｎ〕比较有非常显著性差异（ Ｐ＜ ０ ．０１） ；２ 组对循环系统影响相似（ Ｐ＞０ ．０５） 。Ａ 组病人无１ 例主诉术后头痛。结果提示：脊麻硬膜外联合阻滞是同种异体肾移植手术安全、可靠的麻醉方法之一。

等比重布比卡因CSEA在高龄患者髋关节置换术麻醉中的应用

目的探讨等比重布比卡因腰-硬联合麻醉(CSEA)在高龄患者髋关节置换术中应用的可行性、安全性及有效性。方法 60例髋关节置换术的高龄患者,年龄(88±7)岁,ASAⅠ～Ⅲ级,随机分为2组,每组30例,Ⅰ组为腰-硬联合麻醉组(CSEA),Ⅱ组为连续硬膜外麻醉组(EA)。Ⅰ组局麻药为0.75%布比卡因1.33 mL(布比卡因10 mg),Ⅱ组硬膜外试验用药为1.5%利多卡因3 mL,维持药物为0.5%罗哌卡因。分别记录2组患者的麻醉起效时间、麻醉完善时间、麻醉并发症,记录麻醉前(T0)、麻醉后(T1)及用药后5 min(T2)、15 min(T3)、30 min(T4)、60 min(T5)的MAP、HR、SpO2和RR。结果Ⅰ组麻醉显效时间为(44.0±10.3)s,Ⅱ组为(360.0±60.4)s,2组比较P<0.05,差异具有统计学意义。Ⅰ组病例术中生命体征平稳,虽个别病例出现血压降低,但均小于基础值20%。Ⅱ组3例麻醉平面超过T10,血压下降大于基础值30%,需用麻黄碱纠正。术后随访72 h,2组均无麻醉并发症。结论等比重布比卡因CSEA在高龄患者髋关节置换术中效果确切,是一种安全、简便、有效的麻醉方法。

CSEA下行TURP常见并发症的预防与护理

目的 :为了减少在联合腰麻硬膜外麻醉 (CSEA)下行TURP(经尿道前列腺电切术 )的并发症 ,提高病人的生活质量。方法 :通过对 1 2 0例TURP病人手术过程中截石位摆放的改进 ,冲洗液压力的准确调节 ,以及对椎管内麻醉并发症的认真观察护理。结果 :1 2 0例患者在CSEA下行TURP手术 ,均能达到预期的治疗目的。结论 :对CSEA下行TURP并发症的预防与护理 ,明显提高手术质量 ,临床效果满意。

NTI指导下右美托咪定联合CSEA在老年下肢手术中的应用

目的探讨麻醉趋势指数(NTI)指导下小剂量右美托咪定(DEX)联合腰硬联合麻醉(CSEA)对老年下肢手术患者血流动力学及镇静的影响。方法将76例接受下肢手术的老年患者随机分为2组,各38例。两组均采用小剂量DEX联合CSEA,指导组、对照组分别采用NTI、警觉/镇静(OAA/S)评分调节DEX的输注速度。比较两组不同时点的血流动力学参数、NTI、OAA/S评分及术中不良反应的发生情况。结果与T_0时比较,指导组T_1～T_4时HR、SBP、DBP差异无统计学意义(P>0.05),且均优于对照组(P<0.05)。与T_0时比较,指导组T_1～T_4时NTI、OAA/S评分均降低,且T_2～T_4时NTI高于对照组,OAA/S评分低于对照组(P<0.05)。与对照组比较,指导组术中呼吸抑制的发生率降低(P<0.05)。结论 NTI指导下的小剂量DEX联合CSEA用于老年下肢手术,可提高DEX用量的准确性,达到良好的镇静效果,减少血流动力学波动和术中并发症。

CSEA剖宫产患者仰卧位低血压综合征的体位干预

目的探讨体位干预对腰麻—硬膜外联合麻醉(CSEA)剖宫产患者仰卧位低血压综合征(SHS)的护理效果影响。方法选取我院2016年4月—2017年4月收治的CSEA剖宫产患者100例为研究对象,随机分为研究组和对照组,对照组采取常规护理,研究组在此基础上给予体位干预,比较两组患者的SHS发生情况、低血氧症、用升压药情况。结果麻醉后3 min、5 min、10 min患者SHS发生情况、使用升压药、低血氧症发生情况均低于对照组,差异有统计学意义(P<0.05)。结论体位干预可有效预防CSEA剖宫产患者术中SHS的产生。

CSEA后不同翻平时间对剖宫产麻醉效果的影响

目的探讨产妇由左侧卧位调整到平卧位的时间对腰硬联合阻滞麻醉(CSEA)效果的影响。方法在CSEA下择期剖宫产135例,根据翻平时间随机分为3组:A组在CSEA后翻平时间为1min,B组为2.5min,C组为4min。记录:⑴各产妇入室、蛛网膜下腔注射麻醉药后5min及10min各时间点收缩压(SBP)、舒张压(DBP)、心率(HR)、指末梢氧饱和度(SpO_2);⑵蛛网膜下腔注药5min,7min,9min后的痛觉阻滞平面及痛觉阻滞平面达T6 (理想平面)的例数;⑶蛛网膜下腔注药5min,10min,15min后低血压、心动过速发生比例。结果 3组产妇痛觉阻滞平面差异明显(P<0.05);3组产妇各时间点痛觉阻滞平面达T6 (理想平面)的比例有显著差异(P<0.05);3组产妇各时间点SBP、DBP、HR无明显差异(P>0.05);3组产妇各时间点低血压、心动过速等不良事件的发生率没有明显差异(P>0.05)。结论由左侧卧位恢复到平卧位的时间为1min可更快满足手术要求,且不会造成麻醉平面过高的现象。

CSEA用于老年髋部骨折手术的麻醉效果及对术后肺部并发症的影响

目的探讨硬膜外联合蛛网膜下腔麻醉(CSEA)用于老年髋部骨折手术的麻醉效果,以及对术后肺部并发症的影响。方法选取2016年8月至2019年8月我院收治的80例老年髋部骨折手术患者为研究对象,用抽签法随机分为观察组和对照组,各40例。对照组患者予以硬膜外麻醉,观察组患者采取CSEA。比较两组患者麻醉效果、麻醉药物使用剂量、药物起效时间、感觉阻滞情况(感觉阻滞起效时间、感觉阻滞完善时间)、运动阻滞情况(改良Bromage评分)、术后肺部并发症等指标差异性。结果观察组患者麻醉优良率高于对照组,麻醉药物剂量低于对照组(P<0.05),观察组患者起效时间、感觉阻滞起效时间、感觉阻滞完善时间均短于对照组(P<0.05),观察组患者改良Bromage评分优于对照组(P<0.05),两组患者术后肺部并发症发生率比较,差异无统计学意义(P>0.05)。结论相比于硬膜外麻醉,CSEA应用于老年髋部骨折手术可达到更好的麻醉效果,且麻醉药物剂量低、起效快,不增加肺部并发症的发生。

CSEA在老年骨折合并消化溃疡患者中的应用研究

目的观察腰硬联合麻醉(combined spinal anesthesia,CSEA)在老年骨科手术合并消化溃疡患者中的应用效果.方法选取2014-04/2016-07医院诊治的老年骨科手术合并消化溃疡患者60例,根据麻醉方案不同分为对照组(n=30)和观察组(n=30).对照组采用连续硬膜外麻醉,观察组采用CSEA,比较2组麻醉效果.观察2组术中应激指标肾上腺素、去甲肾上腺素、肾素及血管紧张素Ⅱ水平.结果观察组麻醉起效时间、感觉阻滞时间及运动神经阻滞持续时间,显著短于对照组(P<0.05);观察组麻醉镇痛持续时间,显著高于对照组(P<0.05);观察组麻醉不良反应发生率为10.0%,显著低于对照组的20.0%(P<0.05).结论与连续硬膜外麻醉相比,老年骨科手术合并消化溃疡患者采用CSEA效果理想,值得推广应用.

Regional anesthesia for orthopedic procedures:What orthopedic surgeons need to know

Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Patient evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological assessments.Neuraxial blocks include spinal,epidural,and combined spinal epidural.Upper extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and axillary.Lower extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus block.The choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit assessment.The choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical therapy.Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic reactions.Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications.LAST treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.

CSEA和TIVA均在经皮肾镜碎石术麻醉中的应用效果对比

目的探究腰麻-硬膜外联合麻醉(CSEA)和全凭静脉麻醉(TIVA)在经皮肾镜碎石术(PCNL)麻醉中的应用效果比较。方法选取2017年7月至2018年7月收治本院治疗的肾结石患者40例,根据麻醉方式不同分组,采用CSEA为观察组(20例),采用TIVA为对照组(20例),观察入室时(t0)、改变体位时(t_1)、出室(t_2)、观察组腰麻后15 min(t_(15))、对照组气管插管时(t_i)患者心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO_2)。结果观察组比对照组麻醉苏醒时间长(P<0.05),起效时间短(P<0.05),用药量少(P<0.05);t_1时观察组HR、MAP高于对照组(P<0.05);t_2时HR、MAP低于对照组(P<0.05),SpO_2高于对照组(P<0.05);观察组不良反应发生率为25.0%,对照组为65.0%,观察组显著低于对照组(P<0.05)。结论 CSEA与TIVA两种麻醉方法在PCNL手术中效果不同,应依据患者情况制定个体化麻醉方案。

剖宫产手术中EA和CSEA麻醉方式的应用比较

目的观察剖宫产手术中EA和CSEA麻醉方式的效果,探讨剖宫产手术的较佳麻醉方法。方法回顾性分析比较我院2007年单纯硬膜外麻醉(EA,对照组)剖宫产270例与选择腰麻-硬膜外联合麻醉(CSEA,观察组)610产妇的临床资料。结果两组产妇均无呼吸抑制,血氧饱和度均大于95%,顺利完成手术,新生儿结局l min和5 min Apgar评分均大于8.5,比较无差异(P>0.05);观察组Bromage高、麻醉显效时间短于、不良反应及PDPH发生率低于对照组,肌松程度好,但低血压高于观察组(P<0.05),对通过补充血容量,加大手术床左侧的倾斜度,应用升压药均可以纠正。结论CSE和EA均能够满足剖宫产手术的要求顺利完成手术,但CSEA具起效快、麻醉平面易于控制、肌松完全、术后并发症少等优点,可作为剖宫产术的首选麻醉方法,特别适合于急症胎儿宫内窘迫的产妇。

剖宫产术腰硬联合麻醉(CSEA)中使用小剂量等比重罗哌卡因舒芬太尼价值分析

目的:探讨小剂量等比重罗哌卡因联合舒芬太尼在剖宫产术腰硬联合麻醉中的临床价值。方法:选取某院2018年10月~2019年3月行剖宫产术的足月妊娠患者102例,随机分为联合组(35例,罗哌卡因+舒芬太尼+CSF)、等比重组(38例,罗哌卡因+CSF)和重比重组(28例,罗哌卡因+10%葡萄糖),观察3组孕产妇感觉与运动阻滞起效和消退情况、VAS评分、并发症及新生儿Apgar评分。结果:联合组有效镇痛时间明显高于其余两组(P<0.05);联合组VAS评分明显低于其余两组;联合组和等比重组不良反应发生率明显低于重比重组(P<0.05);3组新生儿Apgar评分无明显差异。结论:小剂量等比重罗哌卡因联合舒芬太尼在剖宫产术腰硬联合麻醉中麻醉效果显著,能明显减轻孕产妇疼痛,且不良反应少,值得推广。

CSEA用于高龄产妇剖宫产术中的麻醉效果及对血流动力学的影响

目的探究腰硬联合麻醉(CSEA)用于高龄产妇剖宫产术中的麻醉效果及对血流动力学的影响。方法以2015年5月至2020年5月收治的300例高龄产妇作为研究对象,均接受剖宫产术分娩,根据术中麻醉方式的不同将其分为对照组和试验组,各150例。对照组实施连续硬膜外麻醉(CEA),试验组则实施CSEA。比较两组的麻醉效果、麻醉起效时间、达到最高阻滞平面时间、镇痛维持时间、镇静镇痛评分、血流动力学指标及不良反应发生情况。结果试验组产妇的麻醉优良率为98.67%,高于对照组的81.33%,差异具有统计学意义(P<0.05);试验组麻醉起效时间、达到最高阻滞平面时间短于对照组,镇痛维持时间长于对照组,差异具有统计学意义(P<0.05);试验组术后48 h的Ramsay镇静评分最高分高于对照组,VAS评分最高分低于对照组,差异具有统计学意义(P<0.05);T2~T5,试验组的HR、SBP、DBP、MAP稳定性均优于对照组,差异具有统计学意义(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论CSEA应用于高龄产妇剖宫产术中能够提高麻醉效果,缩短麻醉起效时间,更好地维持血流动力学的稳定性,且安全性较高。

腰硬联合麻醉下凶险性前置胎盘剖宫产术低血压发生的诱导因素及列线图预测模型的构建

目的探讨腰硬联合麻醉(CSEA)下凶险性前置胎盘剖宫产术中低血压发生的诱导因素并构建列线图预测模型。方法选取玉林市妇幼保健院2020年1月—2023年12月收治的腰硬联合麻醉(CSEA)下凶险性前置胎盘剖宫产术产妇130例作为研究对象,采用自编的一般资料调查表对研究对象基本资料及低血压发生情况进行调查,并依据术中低血压发生情况将其分为低血压组47例和无低血压组83例。对2组一般资料进行单因素分析,采用多因素Logistic回归分析法探讨术中发生低血压的诱导因素。结果单因素分析显示,2组体质量指数、麻醉平面情况、是否为多胎妊娠、术前收缩压情况、手术时间、是否出现Bezold-Jarisch反射比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,体质量指数≥24 kg/m^(2)、麻醉平面≥T8、多胎妊娠、术前收缩压<90 mmHg、手术时间>1.5 h、出现Bezold-Jarisch反射是CSEA下凶险性前置胎盘产妇剖宫产术中发生低血压的独立危险因素(P<0.05)。构建CSEA下凶险性前置胎盘剖宫产术中低血压发生的诱导因素回归方程:Logit(P)=-23.211+1.079×(体质量指数≥24 kg/m^(2))+1.101×麻醉平面(≥T8)+3.193×多胎妊娠+2.214×术前收缩压(<90 mmHg)+4.606×手术时间(>1.5 h)+2.011×出现Bezold-Jarisch反射。分析发现列线图对于存在术前收缩压<90 mmHg人群均有较高区分度及准确度;对列线图模型进行Bootstrap重复抽样1000次,获得校准曲线,计算得到的一致性指数为0.850,说明该列线图模型具备较好的校准度;绘制受试者工作特征(ROC)曲线,其曲线下面积为0.896,95%CI为0.802~0.956,提示预测效能较好。结论体质量指数≥24 kg/m^(2)、麻醉平面≥T8、多胎妊娠、术前收缩压<90 mmHg、手术时间>1.5 h、出现Bezold-Jarisch反射是CSEA下凶险性前置胎盘产妇剖宫产术中低血压发生的诱导因素。

委中穴贴敷对妇科CSEA下腹腔镜术后腰疼的临床观察

目的观察四黄贴敷委中穴对妇科腰硬联合麻下行腹腔镜术后患者腰部疼痛的临床疗效。方法选择2016年1月—2017年1月在本院妇科住院行腹腔镜术后出现腰痛患者44例为研究对象,随机分为2组,其中对照组23例,治疗组21例。对照组采用常规消炎补液治疗和护理措施,治疗组在对照组的干预基础上在术后1 h内采用四黄贴敷委中穴,3 d后观察2组患者腰痛的治疗效果。结果总有效率治疗组为95%,对照组为83%,治疗组临床综合疗效优于对照组。2组比较,差异均具有统计学意义(P<0.05)。结论四黄穴位贴敷委中穴可有效缓解和预防腰麻下妇科腹腔镜术后患者腰痛的症状,其操作简单、安全,易被患者接受,值得在临床上推广。

腰硬联合麻醉分娩镇痛后发热对母婴分娩结局的影响

目的探讨腰硬联合麻醉分娩镇痛后发热对分娩结局的影响,以期改善母婴结局。方法选取2020年1月至2022年6月进行腰硬联合麻醉分娩镇痛的300例产妇作为研究对象,根据镇痛后是否出现发热将产妇分为两组。对照组为未出现发热的产妇,共150例;观察组为出现发热的产妇,共150例。比较两组产妇的阴道操作次数、破膜时间、总产程时间、缩宫素使用比例、分娩方式、产妇不良结局发生率以及新生儿不良结局发生率。结果观察组阴道操作次数(7.56±1.12)次,破膜时间为(11.86±2.03)h,总产程时间为(17.08±2.34)h,使用缩宫素加强宫缩为51例(34.00%),对照组阴道操作次数(5.41±1.04)次,破膜时间为(8.69±1.75)h,总产程时间为(15.04±1.84)h,使用缩宫素加强宫缩为20例(13.33%),两组产妇的阴道操作次数、破膜时间、总产程时间、缩宫素使用比例等指标比较差异均有统计学意义(P<0.001)。观察组产妇自然分娩82例(54.67%),剖宫产45例(30.00%),器械助产23例(15.33%),对照组产妇自然分娩121例(80.67%),剖宫产19例(12.67%),器械助产10例(6.67%),两组产妇的分娩方式比较差异有统计学意义(P<0.05或0.001)。观察组产妇出现低血压、头痛、产后出血、产褥感染等总不良结局发生率为60.67%(91/150),对照组产妇出现低血压、头痛、产后出血、产褥感染等总不良结局发生率为31.33%(47/150),两组产妇总不良结局发生率差异有统计学意义(P<0.001)。观察组出现胎儿窘迫、新生儿窒息、新生儿败血症、新生儿高胆红素血症等总不良结局发生率为40.67%(61/150),对照组出现胎儿窘迫、新生儿窒息、新生儿败血症、新生儿高胆红素血症等总不良结局发生率为22.67%(34/150),两组新生儿总不良结局发生率差异有统计学意义(P<0.001)。结论产时发热是一种临床表现,早发现早预防非常重要。对于产科医生而言,应加强产程管理,掌握阴道操作指征,严格遵循无菌操作,以预防感染性产时发热。同时,要避免产时发热相关因素的叠加,防止非感染性发热的发生。此外,还需综合分析产时发热的原因,动态监测各项指标,仔细鉴别,并采取适宜的产程处理措施。