本文關(guān)鍵詞： 剖宮產(chǎn)術(shù) 麻醉 全身 右美托咪啶 舒芬太尼　出處：《中國(guó)全科醫(yī)學(xué)》2017年S1期 　論文類型：期刊論文

【摘要】：目的探討在剖宮產(chǎn)手術(shù)過程中運(yùn)用右美托咪啶復(fù)合舒芬太尼全身麻醉的麻醉效果以及對(duì)新生兒氧攝取率的影響。方法對(duì)2013年11月—2015年11月期間在瑞安市婦幼保健院產(chǎn)科進(jìn)行剖宮產(chǎn)手術(shù)的100例產(chǎn)婦的病歷資料進(jìn)行回顧性分析,將采用右美托咪啶復(fù)合舒芬太尼全身麻醉的50例產(chǎn)婦設(shè)為觀察組,將只進(jìn)行舒芬太尼麻醉的50例產(chǎn)婦設(shè)為對(duì)照組。對(duì)兩組產(chǎn)婦的麻醉效果、注入麻醉劑后不同時(shí)間點(diǎn)血清皮質(zhì)醇水平、新生兒基本情況以及臍血血?dú)膺M(jìn)行比較。結(jié)果觀察組產(chǎn)婦術(shù)后的第4 h、第8 h、第24 h的視覺模擬(VAS)評(píng)分均低于對(duì)照組(P0.05),兩組產(chǎn)婦麻醉后1 h血清皮質(zhì)醇水平高于麻醉前和術(shù)后24 h(P0.05),觀察組新生兒的麻醉至胎兒娩出的時(shí)間(ID)短于對(duì)照組(P0.05),觀察組1 min新生兒Apgar評(píng)分高于對(duì)照組(P0.05),兩組新生兒的術(shù)前胎心、切開子宮至胎兒娩出時(shí)間(U-D)、氧代謝指標(biāo)(ERO_2)、5 min新生兒Apgar評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組新生兒臍動(dòng)脈血、臍靜脈血的p H值、氧分壓(PO_2)、血紅蛋白(Hb)、二氧化碳分壓(PCO_2)比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論右美托咪啶復(fù)合舒芬太尼聯(lián)合麻醉可增加新生兒氧攝取率,減少麻醉至胎兒娩出的時(shí)間。
[Abstract]:Objective to investigate the anesthetic effect of dexmetomidine combined with sufentanil during cesarean section and its effect on neonatal oxygen uptake. Methods Maternal and Child Health Care in Ruian City from November 2013 to November 2015 was studied. The medical records of 100 pregnant women undergoing cesarean section were retrospectively analyzed. Fifty cases of general anesthesia with dexmetidine combined with sufentanil were set up as observation group and 50 cases of parturient with sufentanil anaesthesia as control group. Serum cortisol levels at different time points after injection of anesthetic, Results the visual analogue VASs in the observation group were lower than those in the control group at 4 h, 8 h and 24 h after anesthesia, and the serum cortisol level in the two groups was higher than that in the control group at 1 h after anesthesia. Before and 24 hours after anesthesia, the time between anesthesia and fetal delivery in the observation group was shorter than that in the control group (P 0.05). The neonatal Apgar score in the observation group 1 min was higher than that in the control group (P 0.05). There was no significant difference in neonatal Apgar scores between the two groups in terms of the time of uterine incision to fetal delivery, the oxygen metabolism index and the neonatal Apgar score of 5 min. There was no significant difference between the two groups in umbilical artery blood, umbilical vein blood pH value, partial pressure of oxygen (PO2P), hemoglobin hbn, carbon dioxide partial pressure PCO2 (PCO2). Conclusion combined anesthesia with dexmetidine and sufentanil can increase oxygen uptake rate and reduce the time between anesthesia and delivery of fetus.
【作者單位】： 浙江省瑞安市婦幼保健院;
【分類號(hào)】：R614

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