硬膜外与腰硬联合麻醉在剖宫产手术中应用的比较研究

目的研究刮宫产手术硬膜外麻醉与腰麻-硬膜外联合阻滞麻醉下各种指标的变化，以探讨剖宫产手术中麻醉对产妇及胎儿的影响作用，从而指导剖宫产手术的最佳麻醉方式。方法随机选择本院采用硬膜外麻醉与腰麻-硬膜外联合阻滞麻醉行剖宫产手术病例60例，其中硬膜外麻醉28例，腰麻-硬膜外联合阻滞麻醉32例。对术中和术后的各个相关指标进行比较分析。结果剖宫产术病例中采用硬膜外麻醉的较腰麻-硬膜外联合阻滞麻醉的显效时间明显延长、阻滞效果显著下降（P〈0．05）；而腰麻-硬膜外联合阻滞麻醉的血压变化与硬膜外麻醉相比较有统计学意义（P〈0．05）。结论在有效控制血压以及孕产妇无特殊情况时，腰麻-硬膜外联合阻滞麻醉可能是临床上剖宫产手术的最佳麻醉方式。

A comparative study of epidural anesthesia and combined spinal anesthesia-epidural anesthesia in cesarean delivery

Objective To study changes of the indexes between epidural anesthesia（EA） and combined spinal anesthesia-epidural anesthesia（CSEA） in cesarean delivery, and to investigate the effect of anesthesia in cesarean delivery to parturient and lotus, then to direct the clinicians to use the optimal anesthesia in cesarean delivery. Methods Patients with cesarean delivery cases （n = 60） were randomly selected. Among them, 20 received EA and 32 received CSEA. The relevant indexes in and after operation were compared and analyzed. Results The effective time of EA pa- tients was obviously longer than that of CSEA patients, and the inhibited effect were significantly decreased （ P 〈 0.05）. The change of blood pressure showed statistical significance between EA and CSEA （P 〈 0.05）. Conclusion CSEA may be the optimal anesthetic method for cesarean delivery when the blood pressure can be effectively controlled and the lying-in women have no special circum- stances.