脊椎-硬膜外联合阻滞下剖宫产术患者并发急性胎盘早剥的原因分析

于1997年1月至2006年12月,温州医学院附属第二医院共有7例患者在脊椎-硬膜外联合麻醉(CSEA)下剖宫产术时,并发急性胎盘早剥.分析表明,CSEA下剖宫产术中发生急性胎盘早剥可能的危险因素为术前焦虑及CSEA后发生仰卧位低血压综合征.CSEA下剖宫产术时虽然急性胎盘早剥很少发生,但其一旦发生将严重危及母婴的生命,应采取有效的预防措施,包括:术前静脉注射咪达唑仑消除患者焦虑;采取针对性措施避免CSEA后发生仰卧位低血压综合征.

Prognostic factors assessment of premature detachment of placenta in cesarean section under combined spinal-epidural anesthesia

Seven cases scheduled for cesarean section following combined spinal-epidural anesthesia,complicating the premature detachment of placenta,which occurred in the 2nd Affdiated Hospital of Wenzhou Medical College from January 1997 to December 2006,were analyzed to determine the risk factors.The results showed that the supine hypotensive syndrome after combined spinal-epidural anesthesia and anxiety before cesarean section were closely related to the premature detachment of placenta.The incidence rate of the premature detachment of placenta after combined spinal-epidural anesthesia is low,but the prermature of detachment of placenta is severe if it occurs,and the effectively prophylactic measures should be taken,including premedication with midazolam to eliminate anxiety before cesarean section and prevention of supine hypotensive syndrome after combined spinal-epidural anesthesia.