腰麻-硬膜外联合麻醉在妊娠合并高血压疾病剖宫产手术中的应用价值

目的 比较单纯硬膜外麻醉（EA）与腰麻-硬膜外联合麻醉（CESA）在妊娠高血压疾病剖宫产手术中的麻醉效果.方法 选取本院2012年6月～2013年5月妊娠高血压综合征剖宫产产妇80例,随机分为EA组和CSEA组各40例.比较两组的麻醉效果、麻醉起效时间、血压以及不良反应发生情况等.结果 CESA组麻醉效果为Ⅰ级的患者占85.0％,显著高于对照组的32.5％,差异有统计学意义（P＜0.05）;CESA组起效时间显著低于EA组,差异有统计学意义（P＜0.05）;CESA组低血压发生率高于EA组,牵拉反应发生率低于EA组,差异有统计学意义（P＜0.05）.结论 CESA用于妊娠高血压疾病剖宫产术麻醉效果好,起效快,值得临床推广应用.

Application value of spinal-epidural combined anesthesia in cesarean section of pregnant women with gestational hypertension

Objective To compare the anesthetic effects of simple epidural anesthesia （EA） and spinal-epidural combined anesthesia （CESA） in the cesarean section of pregnant women with gestational hypertension. Methods Eighty pregnant women with gestational hypertension who received cesarean section in our hospital from June 2012 to May 2013 were selected and randomly divided into EA group and CSEA group,with 40 patients in each group.The anesthetic effects, anesthesia onset time,blood pressure and occurrence of adverse reactions of the two groups were compared. Results In the CESA group,the patients with grade I anesthetic effect accounted for 85.0%,which was higher than 32.5% in the EA group,with significant difference （P〈0.05）.The CESA group had significantly shorter onset time than that of the EA group, with significant difference （P〈O.05）.The CESA had higher incidence of intraoperative hypotension than that of the EA group, but lower incidence of traction reaction than that of the EA group,with significant differences （P〈0.05）. Conclusion In the cesarean section of pregnant women with gestational hypertension,CESA has good anesthetic effects and fast onset, thereby worthy of clinical promotion.