摘要
目的:探讨七氟烷联合硬膜外麻醉对子痫前期剖宫产产妇的麻醉效果,为患者的临床诊疗提供相关指导。方法:选取2018年5月~2019年10月我院接收诊治96例子痫前期剖宫产产妇为研究对象。按照随机单双数法,将所有患者分为对照组和研究组,各48例。对照组产妇予以硬膜外麻醉,研究组产妇予以七氟烷联合硬膜外麻醉。对比两组产妇的麻醉效果、不同时间点[麻醉前(T_(0))、麻醉平稳后(T_(1))、手术开始时(T_(2))、胎儿娩出时(T_(3))、手术结束时(T_(4))]血压及心率指标、术后1min、5min、15min、30min的视觉模拟疼痛评分(VAS)评分,并分析两组产妇麻醉不良反应情况。结果:研究组产妇的麻醉优良率为97.92%,明显高于对照组的68.75%,研究组产妇的麻醉起效时间为(2.41±0.12)min,明显短于对照组的(8.25±0.76)min,差异均有统计学意义;两组产妇T_(0)、T_(1)、T_(2)、T_(4)的舒张压、收缩压及心率指标相比,差异无统计学意义;研究组产妇T_(3)的舒张压、收缩压及心率指标分别为[(69.49±6.97)mmHg、(121.43±10.26)mmHg、(75.31±7.07)次/min],均明显低于对照组的[(75.56±7.12)mmHg、(127.12±13.57)mmHg、(81.62±7.88)次/min],差异有统计学意义;研究组产妇术后1min、5min、15min、30min的VAS评分分别为[(1.68±0.73)分、(2.02±0.46)分、(2.16±0.23)分、(2.31±0.42)分],均明显低于对照组的[(3.34±0.34)分、(4.35±0.34)分、(4.88±0.38)分、(5.42±0.36)分],差异有统计学意义;研究组产妇的麻醉不良反应发生率为6.25%,明显低于对照组的。结论:七氟烷联合硬膜外麻醉对子痫前期剖宫产产妇的麻醉效果满意,明显提高麻醉优良率,缩短麻醉起效时间,有效稳定产妇的血压及心率水平,减轻产妇疼痛水平并减少麻醉不良反应,值得临床广泛应用。
Objective To investigate the anesthesia effect of sevoflurane combined with epidural anesthesia on cesarean delivery in preeclampsia,and provide relevant guidance for the clinical diagnosis and treatment of patients.Methods 96 cases of women with preeclampsia and cesarean section who were admitted to our hospital from May 2018 to October 2019 were selected as the research subjects.According to the random odd-even number method,all patients were divided into a control group and a research group,with 48 cases in each.The women in the control group were received epidural anesthesia,and the women in the study group were received sevoflurane combined with epidural anesthesia.The anesthesia effect,blood pressure and heart rate indicators at different time points[before anesthesia(T_(0)),after anesthesia is stable(T_(1)),at the beginning of surgery(T_(2)),at the time of fetal delivery(T_(3)),at the end of surgery(T_(4))],visual analog pain score(VAS)scores at 1min,5min,15min,30min after operation of the two groups were compared,and the adverse reactions of anesthesia in the two groups of women were analyzed.Results The excellent and good rate of anesthesia in the study group was 97.92%,which was significantly higher than that in the control group(68.75%);the onset time of anesthesia in the study group was(2.41±0.12)min,which was significantly shorter than that in the control group(8.25±0.76)min,the difference was statistically significant;there was no statistically significant difference between the diastolic blood pressure,systolic blood pressure and heart rate index of the maternal T_(0),T_(1),T_(2),T_(4)between the two groups;the diastolic blood pressure,systolic blood pressure and heart rate indexes of maternal T_(3)in the study group were[(69.49±6.97)mmHg,(121.43±10.26)mmHg,(75.31±7.07)beats/min],which were significantly lower than those of the control group[(75.56±7.12)mmHg,(127.12±13.57)mmHg,(81.62±7.88)times/min],the difference was statistically significant;the VAS scores at 1min,5min,15min and 30min after operation in the study group were[(1.68±0.73)points,(2.02±0.46)points,(2.16±0.23)points,(2.31±0.42)points],which were significantly lower than those in the control group[(3.34±0.34)points,(4.35±0.34)points,(4.88±0.38)points,(5.42±0.36)points],and the differences was statistically significant;the incidence of anaesthesia adverse reactions in the study group was 6.25%,which was significantly lower than that in the control group.Conclusion Sevoflurane combined with epidural anesthesia is satisfactory for anesthesia for women with preeclampsia cesarean section,significantly improves the excellent rate of anesthesia,shortens the onset time of anesthesia,effectively stabilizes maternal blood pressure and heart rate levels,reduces maternal pain levels and reduces adverse anesthesia reactions,which is worthy of extensive clinical application.
作者
康晓芳
李晓聪
王金保
张在旺
Kang Xiao-fang;Li Xiao-cong;Wang Jin-bao;Zhang Zai-wang(Department of Anesthesiology,980 Hospital of PLA Joint Logistics Support Force,Shijiazhuang 050000,China)
出处
《湖南师范大学学报（医学版）》
2021年第4期265-269,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
子痫前期
剖宫产
七氟烷
硬膜外麻醉
血流动力学
麻醉效果
preeclampsia
cesarean section
sevoflurane
epidural anesthesia
hemodynamics
anesthesia effect
作者简介
通讯作者:张在旺,E-mail:zhangzaiwang666souhu.com
