摘要
目的了解青岛市三级甲等医院剖宫产术麻醉管理现状,分析其不足之处,为临床干预提供依据。方法调查青岛市三级甲等医院2011年11月麻醉记录单,分析麻醉方式及急症饱胃剖宫产术麻醉选择,术前镇静措施,处理术中低血压、宫缩乏力及恶心呕吐的措施等。结果 2011年11月,青岛市三级甲等医院共实施剖宫产术麻醉956例,其中椎管内麻醉948例(99.2%);急症饱胃剖宫产术多选择腰硬联合麻醉或局部浸润麻醉;均未采用术前镇静措施;均采用麻黄碱及静脉快速输注晶体液或胶体液控制剖宫产术中的低血压;均使用较大剂量缩宫素(10～40U)处理宫缩乏力;防治术中恶心呕吐争议较大且无有效措施。结论青岛市三级甲等医院剖宫产术的主要麻醉方式是椎管内麻醉,目前尚无处理剖宫产术前镇静及防治术中恶心呕吐的有效措施,急症饱胃产妇的麻醉选择、缩宫素及血管活性药物使用等仍然存在不合理之处,有待进一步改进。
Objective To understand the status quo of anesthesia management for cesarean section（CS） in Three A hospitals of Qingdao,and analyze its imperfection and provide basis for clinical intervention.Methods A survey of anesthetic records of November 2011,in Qingdao Three A hospitals,was done.The modalities of anesthesia and anesthetic selection for bellyful emergency CS,preoperative sedative measures,management of hypotension at surgery were analyzed.Results In November of 2011,a total of 956 CSs were performed in Three A hospitals of Qingdao,in which,intraspinal anesthesia was done in 948（99.2%） cases.Combined spinal and epidural anesthesia or local anesthesia was applied for most bellyful emergency CS.No preoperative sedative measures were adopted.Intraoperative hypotension was controlled with ephedrine and fast intravenous infusion of crystalline or colloidal.Uterine inertia was managed with large dose（10-40 U） of oxytocin.Argument remained for prevention and cure of nausea and vomitting at surgery,and yet effective measures were unavailable.Conclusion Intraspinal anesthesia is mainly used for cesarean section in Qingdao Three A hospitals.Now,there are still no effective measures for preoperative sedation,and for nausea and vomitting at surgery.The anesthetic selection for emergency bellyful lying-in women,the application of oxytocin and vasoactive agent are to be further improved.
出处
《青岛大学医学院学报》
CAS
2012年第6期485-487,490,共4页
Acta Academiae Medicinae Qingdao Universitatis
关键词
剖宫产术
麻醉
数据收集
青岛
cesarean section
anesthesia
data collection
Qingdao
作者简介
李井柱（1971-），男，硕士研究生，主治医师。
[通讯作者]赵圣钧（1954-），男，主治医师。
