腰椎蛛网膜下腔联合硬膜外腔阻滞麻醉与连续硬膜外麻醉用于剖宫产术效果比较

目的 比较腰椎蛛网膜下腔联合硬膜外腔阻滞麻醉（CSEA）与连续硬膜外麻醉（CEA）用于剖宫产手术的效果.方法 100例拟择期行剖宫产术的健康产妇,分为CSEA组及CEA组,每组50例.观察并记录产妇麻醉前、麻醉开始后5 min和15 min的血压（BP）、心率（HR）、血氧饱和度（SpO2）,以及麻醉起效时间、麻醉开始至胎儿娩出时间、术中产妇牵拉反应、胎儿娩出时Apgar评分.结果 与CEA组比较,CSEA组麻醉起效时间、麻醉开始至胎儿娩出时间短,运动神经阻滞、镇痛和肌松效果好,牵拉鼓肠等不良反应少（均P＜0.05）.新生儿Apgar评分CSEA组与CEA组差异无统计学意义.结论 CSEA可安全用于健康产妇剖宫产手术,且麻醉效果优于CEA组.

Comparison of the effect between combined spinal epidural anesthesia and continous epidural anesthesia for elective cesarean section

Objective To investigate the feasibility and superiority of combined spinal epidural anesthesia incesarean section.Methods 100 lying-in women who experienced cesarean section were collected and divided into combined spinal epidural anesthesia group(CSEA,n=50)and continuous epidural anesthesia group(CEA,n=50).The change of heart rate(HR),blood pressure(BP)and saturation of peripheral oxygen(SpO2),HR and BP of lyingin womeu in pre-anesthesia,5min,15min post-anesthesia and the time of taking effect,time between beginning of anesthesia and laboar of newborn were observed.The side effects of surgical anesthesia and Apgar score of newborn were compared between the two groups.Results There were no difference in clinical data,change of HR,BP and spO2 between two groups.The anaesthetic time of taking effect and the time between beginning of anesthesia and labour of newborn in group CSEA were shorter than in group CEA(all P＜0.05).Conclusion The combined CSEA and CEA was safe and efficient in cesarean section,and CSEA had greater efficacy than CEA in cesarean section.