本文關(guān)鍵詞： 血小板減少 妊娠 剖宮產(chǎn) 麻醉 安全　出處：《血栓與止血學(xué)》2016年04期 　論文類型：期刊論文

【摘要】：目的探討妊娠合并血小板減少癥產(chǎn)婦剖宮產(chǎn)麻醉方式的選擇及安全性。方法選取2013年2月-2015年2月我院收治的80例妊娠合并血小板減少癥產(chǎn)婦作為研究對(duì)象,所有患者均接受剖宮產(chǎn),按麻醉方式將其分為A、B兩組,A組46例,采用全身麻醉,B組34例,采用局部麻醉,統(tǒng)計(jì)兩組切皮至胎兒娩出時(shí)間,手術(shù)時(shí)間,術(shù)中出血量,并記錄兩組麻醉前后血氧飽和度及臍動(dòng)脈、靜脈血?dú)夥治鼋Y(jié)果,記錄新生兒Apgar評(píng)分結(jié)果,觀察手術(shù)前后患者血小板計(jì)數(shù)變化情況。結(jié)果兩組手術(shù)時(shí)間、術(shù)中出血量對(duì)比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),A組切皮至胎兒娩出時(shí)間為(7.6±2.4)min,低于B組的(12.6±3.1)min,對(duì)比差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組臍動(dòng)脈、靜脈p H值、PCO2水平對(duì)比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),A組臍動(dòng)脈、靜脈PO2水平分別為(25.2±2.1)mm Hg、(34.2±3.3)mm Hg,均高于B組,對(duì)比差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組術(shù)前血小板計(jì)數(shù)對(duì)比差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后A組血小板計(jì)數(shù)上升至(77.8±32.4)×109/L,高于B組,兩組對(duì)比差異有統(tǒng)計(jì)學(xué)意義(P0.05);同時(shí)兩組新生兒Apgar評(píng)分、出生體重、新生兒窒息發(fā)生率對(duì)比差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論對(duì)妊娠合并血小板減少癥產(chǎn)婦行剖宮產(chǎn)術(shù)者采用全身麻醉,鎮(zhèn)痛確切,安全性高,不會(huì)增加新生兒窒息發(fā)生率。
[Abstract]:Objective to explore the choice and safety of anesthesia in cesarean section of pregnant women with thrombocytopenia. Methods 80 pregnant women with thrombocytopenia were selected from February 2013 to February 2015 in our hospital. As a research object. All the patients underwent cesarean section and were divided into two groups: group A (n = 46) and group B (n = 34). The operation time, intraoperative bleeding volume, blood oxygen saturation, umbilical artery and venous blood gas before and after anesthesia were recorded, and the neonatal Apgar score was recorded. Results there was no significant difference in the operation time and blood loss between the two groups (P 0.05). The time from incision to delivery in group A was 7.6 鹵2.4 minutes, which was lower than that in group B (12.6 鹵3.1 min), and the difference was statistically significant (P 0.05). There was no significant difference in the level of PCO2 in umbilical artery and vein between two groups. The PO2 level of vein in group A was 25.2 鹵2.1 mm Hg, respectively. 34.2 鹵3.3 mm Hg was higher than that in group B, and the difference was statistically significant (P 0.05). There was no significant difference in platelet count between the two groups before operation (P 0.05). After operation, the platelet count in group A increased to 77.8 鹵32.4 脳 10 9 / L, which was higher than that in group B. The difference between the two groups was statistically significant (P 0.05). At the same time, two groups of newborn Apgar score, birth weight. There was no significant difference in the incidence of neonatal asphyxia (P 0.05). Conclusion General anesthesia is effective and safe for pregnant women with thrombocytopenia undergoing cesarean section. There is no increase in the incidence of neonatal asphyxia.
【作者單位】： 陜西榆林市第一醫(yī)院;
【分類號(hào)】：R614
【正文快照】： 妊娠合并血小板減少癥產(chǎn)婦中,僅有極少部分有其典型癥狀及體征,可作預(yù)處理,其中大部分均可能因凝血功能功能障礙引發(fā)分娩期間產(chǎn)婦大出血及新生兒顱內(nèi)血腫等并發(fā)癥,此類產(chǎn)婦通常選擇剖宮產(chǎn)方式。但對(duì)剖宮產(chǎn)術(shù)麻醉方式的選擇臨床上尚且存在一定爭(zhēng)議[1]。部分觀點(diǎn)表示,妊娠合并嚴(yán)

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