摘要
目的 探讨重度子痫前期剖宫产麻醉方法的选择。方法 518例重度子痫前期剖宫产患者以其术前凝血功能的Plt的值分为硬膜外组（E组Ph〉70×10^9／L）和局麻加静脉麻醉组（L组Ph〈70×10^9／L），观察两组患者术前SBP、DBP、Hb、Plt、PT、APTT,术中最高和最低SBP、DBP术中输液量，升压药使用人次及比例，术毕要求镇痛时间，术后肺水肿发生率，新生儿出生后1min和5minApgar评分。结果 两组患者的术前BP、Hb、PT、APTT无显著性差异、仅Pit在L组明显低于E组。两组患者的术中最高BP和最低BP、两组新生儿出生1min和5min Apgar评分低于7分的百分率均无显著性差异；在L组中使用升压药物的患者比E组少，术毕要求切口疼痛治疗的时间早于E组。两组术中输液量、术毕肺水肿发生率均无显著性差异（P〉0．05）。结论 硬膜外麻醉和局麻加静脉麻醉均是可选择的安全麻醉方法。重度子痫前期剖宫产的麻醉选择主要取决于患者术前凝血功能的Pit。当Pit〉70×10^9时如无其他硬膜外麻醉禁忌，可以选择硬膜外麻醉。
Objective To investigate the selection of methods of section anaesthesia in severe preeclampsia. Methods According to the Pit,518 patients with severe pre - eclampsia were divided into two groups： E group（ Pit 〉 70 ×10^9/L） and L group（Pit 〈 70×10^9/L）. SBP,DBP,Hb, Pit, PT and APTT were observed in two groups before operations. The highest and lowest SBP and DBP during operations,cases and ratio of pressor drugs,time needed to anaesthesia after operations,the rate of pulmonary edema after operations and the newborns＇ Apgar assessment at 1 and 5 minutes were also observed. Results In the two groups,there had no statistically differences in BP,Hb,PT and APTT,with Pit in group L apparently lower than that in group E. No statistically differences were found in the highest BP and the lowest BP. The rate of Apgar scores,which were lower than 7 in two groups, had no significant difference. Patients from group G had less pressor drugs assumption than that in group E. Time to begin with the pain therapy in group L was earlier than that of group E. And fluid account during operations and pulmonary edema rate had no significant differences between two groups（P 〉 0.05）. Conclusions Epidural anesthesia and local anesthesia with intravenous anesthesia are both safe anesthesia methods. The section anesthesia method are mainly decided by patients＇ Pit. Epidural anesthesia is suitable for those with Pit 〉 70×10^9 and no other contraindications.
出处
《医学信息（手术学分册）》
2006年第5期31-34,共4页
Medical Information Operations Sciences Fascicule
关键词
重度子痫前期
剖宫产
硬膜外麻醉
局麻加静脉麻醉
PLT
severe pre - eclampsia
cesarean section
epidural anesthesia
local anesthesia with intravenous anesthesia Pit
