發(fā)布時(shí)間：2018-05-28 01:10

  本文選題：超聲引導(dǎo) + 腹部神經(jīng)阻滯　； 參考：《臨床麻醉學(xué)雜志》2017年10期

【摘要】：目的觀察超聲引導(dǎo)下腹部神經(jīng)阻滯聯(lián)合瑞芬太尼輸注在血小板減少產(chǎn)婦剖宮產(chǎn)手術(shù)中的應(yīng)用效果。方法選擇妊娠合并血小板減少(Plt7.0×109/L),術(shù)前無(wú)早產(chǎn)、無(wú)胎兒窘迫,且初次行剖宮產(chǎn)的產(chǎn)婦60例,年齡20~32歲,ASAⅠ或Ⅱ級(jí),分為腹橫肌平面阻滯、髂腹下-髂腹股溝神經(jīng)阻滯聯(lián)合瑞芬太尼組(T組)和全麻組(G組),每組30例。兩組術(shù)后均行PCIA。比較兩組產(chǎn)婦從切皮至胎兒剖出的時(shí)間,麻醉前、切皮即刻及胎兒剖出時(shí)的血流動(dòng)力學(xué)變化和術(shù)后48 h鎮(zhèn)痛泵按壓次數(shù)。比較胎兒剖出后的Apgar評(píng)分。結(jié)果 T組切皮至胎兒剖出時(shí)間明顯長(zhǎng)于G組(P0.05),但兩組均在6 min內(nèi)取出胎兒。與G組比較,胎兒剖出時(shí)T組產(chǎn)婦BP明顯上升,HR明顯加快(P0.05),但產(chǎn)婦未出現(xiàn)明顯不適癥狀。與G組比較,T組術(shù)后48 h鎮(zhèn)痛泵按壓次數(shù)明顯減少(P0.05),鎮(zhèn)痛效果完善。胎兒剖出后1 min T組新生兒Apgar評(píng)分明顯高于G組新生兒(P0.05)。結(jié)論超聲引導(dǎo)下腹部神經(jīng)阻滯聯(lián)合瑞芬太尼輸注應(yīng)用于剖宮產(chǎn)手術(shù)時(shí)對(duì)新生兒影響較小,術(shù)后鎮(zhèn)痛效果理想。
[Abstract]:Objective to observe the effect of ultrasound-guided lower abdominal nerve block combined with remifentanil infusion in cesarean section for patients with thrombocytopenia. Methods A total of 60 pregnant women, aged 20 to 32 years, who underwent cesarean section without premature delivery or fetal distress, were divided into abdominal transverse muscle block (ASA 鈪，

本文編號(hào)：1944590