腰麻—硬膜外联合麻醉在急诊剖宫产术中的应用探讨

李文锋

（西电集团医院，陕西 西安，710077）

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摘要：

目的 探讨腰麻―硬膜外联合麻醉应用于急诊剖宫产术中的麻醉效果及安全性。方法 选择2014年6月至2016年5月在本院行急诊剖宫产术的72例产妇，随机将其分为对照组和观察组，各36例。对照组采用硬膜外麻醉，观察组采用腰麻―硬膜外联合麻醉，比较两组麻醉相关指标、不良反应、胎儿脐动脉血气分析及Apgar 评分情况。结果 观察组麻醉起效时间（2.56±1.26）min、麻醉平面至T6的时间（5.47±3.17）min、麻醉至胎儿娩出时间（11.69±2.69）min、手术时间（45.29±10.36）min 和最大运动阻滞程度评分（2.98±0.68）分，均显著优于对照组，差异有统计学意义（P<0.05）。观察组新生儿PaCO₂ 值显著低于对照组，PaO₂ 值显著高于对照组，差异具有统计学意义（P<0.05）。观察组BE值、5min Apgar评分与对照组比较，差异无统计学意义（P>0.05）。观察组麻醉不良反应发生率为22.22%，显著低于对照组的47.22%，差异有统计学意义（P<0.05）。结论 腰麻―硬膜外联合麻醉应用于急诊剖宫产术中麻醉效果安全可靠。

关键词：急诊；剖宫产术；腰麻―硬膜外联合麻醉

中图分类号：R614文献标志码：A文章编号：2096-1413(2017)13-0131-03

Application of combined spinal-epidural anesthesia in emergency cesarean section
LI Wen-Feng
(Xi an XD Group Hospital, Xi an 710077, China)

ABSTRACT: Objective To investigate the effect and safety of combined spinal-epidural anesthesia in emergency cesarean section. Methods From June 2014 to May 2016, 72 cases of pregnant women underwent emergency cesarean section in our hospital were randomly divided into control group and observation group, with 36 cases in each group. The control group was given epidural anesthesia, and the observation group was given combined spinal -epidural anesthesia, then the anesthesia-related indicators, adverse reactions, fetal umbilical artery blood gas analysis and Apgar score were compared between the two groups. Results The anesthesia onset time was (2.56±1.26) min, the time of the anesthesia plane to T6 was (5.47±3.17) min, the time of anesthesia to fetal childbirth time was (11.69±2.69) min, the time of operation was (45.29±10.36) min and the maximum degree of movement was (2.98±0.68) in the observation group, which were significantly better than those in the control group, the differences were statistically significant (P<0.05). The PaCO₂ of the observation group was significantly lower than that of the control group, PaO₂ was significantly higher than that of the control group, the differences were statistically significant (P<0.05). There was no significant difference in BE value and 5 min Apgar score between the observation group and the control group (P>0.05). The incidence of adverse reactions of the observation group was 22.22% , which was significantly lower than 47.22% of the control group, the difference was statistically significant (P <0.05). Conclusion The effect of combined spinal -epidural anesthesia in emergency cesarean section
anesthesia is safe and reliable.
KEYWORDS: emergency; cesarean section; combined spinal-epidural anesthesia

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