妊娠合并血小板减少剖宫产麻醉方式选取及安全性分析

发布时间：2018-01-30 00:46

本文关键词： 血小板减少妊娠剖宫产麻醉安全　出处：《血栓与止血学》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨妊娠合并血小板减少症产妇剖宫产麻醉方式的选择及安全性。方法选取2013年2月-2015年2月我院收治的80例妊娠合并血小板减少症产妇作为研究对象,所有患者均接受剖宫产,按麻醉方式将其分为A、B两组,A组46例,采用全身麻醉,B组34例,采用局部麻醉,统计两组切皮至胎儿娩出时间,手术时间,术中出血量,并记录两组麻醉前后血氧饱和度及脐动脉、静脉血气分析结果,记录新生儿Apgar评分结果,观察手术前后患者血小板计数变化情况。结果两组手术时间、术中出血量对比差异无统计学意义(P0.05),A组切皮至胎儿娩出时间为(7.6±2.4)min,低于B组的(12.6±3.1)min,对比差异有统计学意义(P0.05);两组脐动脉、静脉p H值、PCO2水平对比差异无统计学意义(P0.05),A组脐动脉、静脉PO2水平分别为(25.2±2.1)mm Hg、(34.2±3.3)mm Hg,均高于B组,对比差异有统计学意义(P0.05);两组术前血小板计数对比差异无统计学意义(P0.05),术后A组血小板计数上升至(77.8±32.4)×109/L,高于B组,两组对比差异有统计学意义(P0.05);同时两组新生儿Apgar评分、出生体重、新生儿窒息发生率对比差异均无统计学意义(P0.05)。结论对妊娠合并血小板减少症产妇行剖宫产术者采用全身麻醉,镇痛确切,安全性高,不会增加新生儿窒息发生率。
[Abstract]:Objective to explore the choice and safety of anesthesia in cesarean section of pregnant women with thrombocytopenia. Methods 80 pregnant women with thrombocytopenia were selected from February 2013 to February 2015 in our hospital. As a research object. All the patients underwent cesarean section and were divided into two groups: group A (n = 46) and group B (n = 34). The operation time, intraoperative bleeding volume, blood oxygen saturation, umbilical artery and venous blood gas before and after anesthesia were recorded, and the neonatal Apgar score was recorded. Results there was no significant difference in the operation time and blood loss between the two groups (P 0.05). The time from incision to delivery in group A was 7.6 卤2.4 minutes, which was lower than that in group B (12.6 卤3.1 min), and the difference was statistically significant (P 0.05). There was no significant difference in the level of PCO2 in umbilical artery and vein between two groups. The PO2 level of vein in group A was 25.2 卤2.1 mm Hg, respectively. 34.2 卤3.3 mm Hg was higher than that in group B, and the difference was statistically significant (P 0.05). There was no significant difference in platelet count between the two groups before operation (P 0.05). After operation, the platelet count in group A increased to 77.8 卤32.4 脳 10 9 / L, which was higher than that in group B. The difference between the two groups was statistically significant (P 0.05). At the same time, two groups of newborn Apgar score, birth weight. There was no significant difference in the incidence of neonatal asphyxia (P 0.05). Conclusion General anesthesia is effective and safe for pregnant women with thrombocytopenia undergoing cesarean section. There is no increase in the incidence of neonatal asphyxia.
【作者单位】：陕西榆林市第一医院;
【分类号】：R614
【正文快照】： 妊娠合并血小板减少症产妇中,仅有极少部分有其典型症状及体征,可作预处理,其中大部分均可能因凝血功能功能障碍引发分娩期间产妇大出血及新生儿颅内血肿等并发症,此类产妇通常选择剖宫产方式。但对剖宫产术麻醉方式的选择临床上尚且存在一定争议[1]。部分观点表示,妊娠合并严

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