不同麻醉方式对妊娠合并重度肺动脉高压患者剖宫产术后结局的影响

发布时间：2018-06-15 11:32

本文选题：妊娠 + 肺动脉高压　；参考：《实用妇产科杂志》2015年04期

【摘要】：目的:探讨不同麻醉方式对妊娠合并重度肺动脉高压(PAH)患者剖宫产妊娠结局及术后情况的影响。方法:回顾性分析21例妊娠合并PAH患者的临床资料,按麻醉方式分为椎管内麻醉12例(腰麻-硬膜外联合麻醉7例,连续硬膜外麻醉5例),全身麻醉9例。结果:两组患者年龄、孕周、孕产史、是否定期产检、心脏手术史、心脏病类型、心功能、孕期合并症差异无统计学意义(P0.05);两组新生儿窒息率、新生儿死亡率、产妇死亡率差异无统计学意义(P0.05);椎管内麻醉组患者的术后机械通气时间、ICU入住时间、术后总住院时间短于全身麻醉组,差异有统计学意义(P0.05)。结论:在改善妊娠结局方面,椎管内麻醉并不一定优于全身麻醉,但可以显著减少患者术后机械通气时间、ICU入住时间以及术后总住院时间,有选择优势。
[Abstract]:Objective: to investigate the effect of different anesthetic methods on the outcome of cesarean section and postoperative conditions in patients with severe pulmonary hypertension (PAH). Methods: the clinical data of 21 cases of pregnancy complicated with PAH were retrospectively analyzed. According to the anesthetic method, 12 cases were divided into three groups: spinal canal anesthesia (7 cases), continuous epidural anesthesia (5 cases), general anesthesia (9 cases), combined spinal-epidural anesthesia (7 cases), continuous epidural anesthesia (5 cases) and general anesthesia (9 cases). Results: there was no significant difference in age, gestational age, history of gestation, history of pregnancy, regular birth examination, history of cardiac surgery, type of heart disease, cardiac function and complications during pregnancy (P 0.05), the rate of neonatal asphyxia and neonatal mortality in the two groups were not significantly different. There was no significant difference in maternal mortality (P 0.05). The time of postoperative mechanical ventilation was less than that of general anesthesia group, and the total hospitalization time was shorter than that of general anesthesia group (P 0.05). Conclusion: in improving pregnancy outcome, intraspinal anesthesia is not necessarily superior to general anesthesia, but it can significantly reduce the time of mechanical ventilation after operation, the time of ICU stay and the total hospital stay after operation.
【作者单位】：浙江省杭州市第三人民医院;浙江省杭州市第一人民医院;
【分类号】：R614

【参考文献】