椎管内麻醉和全身麻醉对前置胎盘剖宫产产妇及新生儿的影响

目的探讨椎管内麻醉和全身麻醉对前置胎盘剖宫产产妇及新生儿的影响。方法选取我院收治的73例胎盘前置产妇,根据随机数字表法将其分为椎管内麻醉组(36例)和全身麻醉组(37例)。比较两组产妇的血流动力学指标、术中麻醉效果、产妇术中情况及新生儿情况。结果T1、T2、T3、T4时,两组产妇的MAP、HR均明显低于T0时,但全身麻醉组的MAP、HR均明显高于椎管内麻醉组,差异具有统计学意义(P<0.05);T1、T2、T3、T4时,两组产妇的Sp O2比较,差异无统计学意义(P>0.05)。全身麻醉组产妇术中麻醉效果优良率明显高于椎管内麻醉组,差异具有统计学意义(P<0.05)。全身麻醉组的手术时间明显长于椎管内麻醉组,术中出血量明显多于椎管内麻醉组,差异具有统计学意义(P<0.05)。两组新生儿的断脐时间、脐动脉血气分析相关指标及出生后1 min和5 min的Apgar评分比较,差异无统计学意义(P>0.05)。结论前置胎盘剖宫产术中行全身麻醉的效果较佳,且对产妇血流动力学影响小、不会影响新生儿安全,但会延长手术时间,增加术中出血量,故术前需给予产妇针对性处理。

Effects of intrathecal anesthesia and general anesthesia on the parturient and newborn in cesarean section of placenta previa

Objective To investigate the effects of intrathecal anesthesia and general anesthesia on the parturient and newborn in cesarean section of placenta previa.Methods A total of 73 parturients with placenta previa admitted in our hospital were selected and divided into intrathecal anesthesia group(36 cases) and general anesthesia group(37 cases)according to the random number table method.The maternal hemodynamic indexes,intraoperative anesthesia effect,intraoperative condition of parturient and newborn condition in the two groups were compared.Results At T2,T3 and T4,the MAP and HR of the two groups were significantly lower than those at T0,but the MAP and HR in the general anesthesia group were significantly higher than those in the intrathecal anesthesia group,the differences were statistically significant(P<0.05);at T1,T2,T3 and T4,there was no significant difference in SpO2 between the two groups(P>0.05).The excellent rate of anesthesia effect in the general anesthesia group was significantly higher than that in the intrathecal anesthesia group,the difference was statistically significant(P<0.05).The operation time in the general anesthesia group was significantly longer than that in the intrathecal anesthesia group,and the amount of bleeding during operation was significantly more than that in the intrathecal anesthesia group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in umbilical cord breaking time,related indexes of umbilical artery blood gas analysis and Apgar scores at 1 and 5 min after birth(P>0.05).Conclusion The effect of general anesthesia in cesarean section of placenta previa is better,and it has little effect on maternal hemodynamics and does not affect the safety of newborns,but it can prolong the operation time and increase the amount of bleeding during the operation.Therefore,targeted treatment should be given to parturient before operation.