钢丝加强硬膜外导管在剖宫产麻醉中的应用效果

发布时间：2018-05-17 13:10

本文选题：剖宫产 + 硬膜外导管　；参考：《蚌埠医学院学报》2016年06期

【摘要】：目的:观察钢丝加强硬膜外导管在剖宫产麻醉中的应用效果。方法:腰硬联合麻醉下行剖宫产术,且要求硬膜外术后镇痛的产妇400例,采取随机数字表法分为普通硬膜外导管组(A组)和钢丝加强硬膜外导管组(B组),各200例。常规行腰硬联合阻滞操作,2组置入相应的硬膜外导管。观察置管困难、置管异感、回抽见血、脑脊液,注药遇阻,拔管困难,拔管时导管被拉长,拔管后出血的发生率。记录术后镇痛期间穿刺部位不适程度及发生率。结果:B组置管困难、置管异感、回抽见血、注药遇阻、导管被拉长和拔管后出血发生率均低于A组(P0.05~P0.01)。B组患者术后镇痛期间穿刺部位不适发生率明显高于A组(P0.01)。2组患者未发生导管打折,误入蛛网膜下腔或发生硬膜外血肿。结论:钢丝加强硬膜外导管在剖宫产术中安全性优于普通硬膜外导管,但预留的导管可引起穿刺部位术后疼痛不适。
[Abstract]:Objective: To observe the effect of steel wire strengthening epidural catheter in caesarean section anesthesia. Methods: 400 cases of parturients undergoing caesarean section under combined spinal epidural anesthesia and requiring postoperative epidural analgesia were divided into ordinary epidural catheter group (group A) and steel wire strengthening epidural catheter group (group B), each with 200 cases. Block operation, 2 groups were placed with the corresponding extradural catheter. Observe the difficulty of placing the tube, the intubation dissimilarity, the withdrawal of blood, the cerebrospinal fluid, the obstruction of the injection, the difficulty of drawing the tube, the lengthening of the catheter and the incidence of bleeding after extubation. Record the degree of discomfort and the incidence of the puncture site during the postoperative analgesia. Results: in the B group, the difficulty of placing the tube, the intubation of the different feeling, the withdrawal of the intubation of the different feeling, the withdrawal of the blood, injection, and the injection of the blood were taken. The incidence of bleeding of the catheter was prolonged and after extubation was lower than that of group A (P0.05~P0.01).B group.B. The incidence of discomfort of the puncture site was significantly higher than that of group A (P0.01).2 group (P0.01).2 patients, which had not been discounted in the subarachnoid cavity or epidural hematoma. Conclusion: the safety of the steel wire strengthened by the steel wire is superior to the subarachnoid catheter in the cesarean section. In the common epidural catheter, the reserved catheter can cause postoperative pain and discomfort at the puncture site.
【作者单位】：广州医科大学附属深圳沙井医院麻醉科;
【基金】：深圳市宝安区科技计划-社会公益(医疗卫生类)项目(2014188)
【分类号】：R614

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