取胎前硬膜外应用曲马多于剖宫产寒战的疗效观察

目的观察取胎前硬膜外应用曲马多于剖宫产寒战的防治疗效。方法将360例在腰硬联合麻醉下行子宫下段剖宫产术的产妇随机分为Ⅰ组取胎后硬膜外注射曲马多1mg/kg（用生理盐水稀释到5ml），Ⅱ组取胎前硬膜外注射曲马多1mg/kg（用生理盐水稀释到5ml），每组180例。记录胎儿出生后Apgar评分、寒战发生率及分级和寒战转归情况。结果两组胎儿出生后Apgar评分分别为（9.2±0.7）、（9.4±0.5），组间比较无显著性差异（p〉0.05）；取胎前用药组产妇麻醉后寒战的发生率明显低于取胎后用药组（p〈0.05）；两组药物治疗寒战转归情况：Ⅰ组26例有24例有效但恢复时间长，2例无效；Ⅱ组2例有效，恢复时间迅速。结论取胎前硬膜外应用曲马多于剖宫产防治寒战具有较好的临床疗效。

Taiqian take epidural application of tramadol more than observe the effects of the chill section

Objective To observe the application of epidural Taiqian take tramadol than shivering section of the prevention and treatment efficacy. Methods 360 cases of lumbar epidural anesthesia in the downlink lower segment cesarean section were randomly divided into the maternal fetal Ⅰ group after taking epidural injection tramadol 1mg/kg （diluted with saline to 5ml）, Ⅱ group take Taiqian Epidural injection tramadol 1mg/kg （diluted with saline to 5ml）, each of 180 cases. Records of the fetus after birth, Apgar score, the incidence of shivering and shivering vest and grading the situation. The results of the two groups after the birth of the fetus were Apgar score （9.2 ± 0.7）, （9.4 ± 0.5）, inter-group comparison was no significant difference （p〉 0.05）; Taiqian take medication group after the chill of maternal anesthesia were significantly lower After taking in the fetal treatment group （p 〈0.05）; two groups of shivering medication transferred the case： Ⅰ group of 26 cases, but there are 24 cases of effective long recovery time, 2 null and void; Ⅱ group 2 cases effective, rapid recovery time. Conclusion Taiqian take epidural application of tramadol than with cesarean section shivering better prevention and treatment of clinical efficacy.