腰-硬联合麻醉与硬膜外腔麻醉用于剖宫产术效果及对新生儿的影响

目的：观察腰-硬联合麻醉（ SCEA）与连续硬膜外腔麻醉（ CEA）用于剖宫产术临床效果及对新生儿Apgar评分的影响。方法选择我院行剖宫产术产妇900例，依据麻醉方式不同分为CEA组与SCEA组各450例，对比2组麻醉效果、麻醉诱导至胎儿娩出时间（ I-D）、子宫切开至胎儿娩出时间（ U-D）、手术时间及新生儿娩出后1、5、10 min Apgar评分。结果 SCEA组麻醉1级率显著高于CEA组（ P﹤0.05）；CEA组的手术时间、I-D、U-D时间均高于SCEA组（ P﹤0.05）。CEA组胎儿出生后1、5、10 min 新生儿Apgar评分均低于SCEA组（ P﹤0.05）。结论 SCEA用于剖宫产术具有起效快、麻醉效果完善、肌松满意的特点，由于I-D时间的缩短，可显著降低新生儿宫内窘迫、缺氧、窒息等并发症的发生率，有利于母婴预后。

Combined spinal-epidural anesthesia and epidural anesthesia on cesarean section and newborns

Objective To observe the clinical efficacy of combined spinal-epidural anesthesia( CSEA)and contin-uous epidural anesthesia( CEA)in application of cesarean section and the effect on Apgar scores in newborns. Methods A total f 900 pregnant women were divided into CSEA group and CEA group according to different anesthesia methods with 450 cases in each group. The anesthetic effect,I-D,U-D,operation time,Apgar scores 1,5,10 min after delivery in the two groups were compared. Results Level 1 rate of anesthesia in CSEA group was significantly higher than that in CEA group(P﹤0. 05). The operation time,I-D,and U-D in CEA group were significantly higher than those in CSEA group(P﹤0. 05). Apgar 1,5,10 min after delivery in CEA group were significantly lower than those in CSEA group (P﹤0. 05). Conclusion CSEA in application of cesarean section is characterized by rapid effect taking,perfect anes-thetic effect,and satisfying muscular relaxation,and can significantly reduce the occurrence rate of complications of in-trauterine distress,hypoxia,and asphyxia,which is beneficial for the prognosis of mother and child.