舒芬太尼在高危妊娠剖宫产中的应用探讨

发布时间：2018-01-13 22:08

本文关键词：舒芬太尼在高危妊娠剖宫产中的应用探讨　出处：《北方药学》2016年12期 　论文类型：期刊论文

【摘要】：目的:应用舒芬太尼对高危妊娠剖宫产产妇进行全身麻醉和硬膜外麻醉,探讨对新生儿和产妇的影响。方法:选择高危妊娠产妇56例进行剖宫产手术,分成对照组(硬膜外麻醉)和观察组(全身麻醉)。记录术前、手术开始时、胎儿娩出时及手术完成高危产妇的心率(HR)、收缩压(SBP)、舒张压(DBP);进行胎儿娩出后1min、5min Apgar评分及监测新生儿脐动血酸碱度(p H)、二氧化碳分压(PCO2)和氧分压(PO2)并计算新生儿给氧、纳洛酮处理率;记录剖宫产术中产妇失血量、胎儿娩出时间。结果:剖宫产中各时点的HR、DBP比较两组无显著差异;手术开始时硬膜外麻醉组SBP低于全身麻醉组,有显著差异(P0.05);剖宫产术中失血量、胎儿娩出时间、胎儿娩出后Apgar评分、新生儿给氧和纳洛酮处理率、新生儿脐动脉血气,两组比较无显著差异(P0.05);麻醉及手术过程中低血压发生率,硬膜外麻醉组高于全身麻醉组,有显著差异(P0.05)。结论:舒芬太尼在高危妊娠剖宫产中对产妇及新生儿影响较小,且使用舒芬太尼进行全身麻醉时较硬膜外麻醉低血压等不良反应少。
[Abstract]:Objective: to study the influence of sufentanil on newborn and parturient by general anesthesia and epidural anesthesia in high risk pregnancy cesarean section. Methods: 56 pregnant women with high risk pregnancy were selected for cesarean section. The patients were divided into two groups: control group (epidural anesthesia) and observation group (general anesthesia). Before operation, at the beginning of operation, at the time of delivery of the fetus, and at the time of completion of the operation, the heart rate and HRV, systolic pressure and SBP of the high-risk parturient were recorded. Diastolic blood pressure (DBP); One minute after delivery, the Apgar score was 5 minutes and the pH of umbilical blood was monitored. Carbon dioxide partial pressure (PCO _ 2) and oxygen partial pressure (P _ 2O _ 2)) were used to calculate neonatal oxygen supply and naloxone treatment rate. Results: there was no significant difference in HR-DBP between the two groups at different time points during cesarean section. At the beginning of operation, SBP in epidural anesthesia group was lower than that in general anesthesia group (P 0.05). There was no significant difference between the two groups in blood loss, fetal delivery time, Apgar score after delivery, neonatal oxygen supply and naloxone treatment rate and umbilical artery blood gas in the two groups. The incidence of hypotension during anesthesia and operation was higher in epidural anesthesia group than in general anesthesia group (P 0.05). Conclusion: sufentanil has little effect on parturient and newborn in high risk pregnancy cesarean section. There were fewer adverse reactions such as hypotension with sufentanil in general anesthesia than in epidural anesthesia.
【作者单位】：厦门市湖里区妇幼保健院;
【分类号】：R614
【正文快照】： 1概述孕妇在妊娠期发生的各种病理因素,如果对孕妇、胎儿、新生儿可能造成危害或导致难产,被称为高危妊娠(high riskprognancy HRP)。病理因素包括前置胎盘和胎盘早剥、妊娠高血压综合征、羊水栓塞等,根据不同高危妊娠病情需采取不同的麻醉方式。如对于前置胎盘和胎盘早剥的高

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