连续腰麻在妊娠合并血小板减少症剖宫产术麻醉中de应用.pdfVIP

安 徽 医 药 AnhuiMedicalandPharmaceuticalJournal2014Jul；18(7) ·1353· 连续腰麻在妊娠合并血小板减少症剖宫产术麻醉中的应用 张 宁，徐铭军 (首都医科大学附属北京妇产医院麻醉科，北京 100026) 摘要：目的 探讨妊娠合并血小板减少症产妇剖官产术连续腰麻的可行性。方法 选择妊娠合并血小板减少症产妇剖宫产 患者52例，连续腰麻组29例，全身麻醉组23例，分析两组患者血小板计数、出血量等基本情况，记录两种麻醉过程血压、心率 变化及对于新生儿的影响。结果 两组在血小板计数、出血量等方面均无统计学差异。连续腰麻组产妇在新生儿 Apgar评分 1min，5min无影响与全麻组比较有统计学差异。两组血压在麻醉开始后均下降，但在麻醉后 10min连续腰麻组血压下降幅 度大于全麻组有统计学差异。结论 连续腰麻在妊娠合并血小板减少症产妇剖宫产麻醉中可安全有效实施。 关键词 ：连续腰麻；妊娠合并血小板减少症；剖宫产术 doi：lO．3969／j．issn．1009—6469．2014．07．054 Application ofcontinuousspinalanesthesiain cesareansectionofpatients withpregnancycombinedwith thrombocytopenia ZHANGNing，XUMing—jun (DepartmentofAnesthesiology，BeijingObstetricsandGynecologyHospital，Beijing 100026，China) Abstract：0bjective Toexaminethefeasibilityofcontinuousspinalanesthesiaincesareansectionofpatientswithpregnancycorn— binedwiththrombocytopenia．M ethods Fifry—twopatientsundergoingcesareansectionofparturientwiththrombocytopeniawereell— rolledinthisstudy，29parturientreceivedCSAand23parturientreceivedgeneralanesthesia(GA)．Wecomparedthebasicinformation ofbloodplateletcountandbloodingvolume，analyzedthebloodpressure，heart rateduringanesthesiaandApgarscorebetween two groups．Results Therewerenosignificantdifferencesinbloodplateletcountandbleedingvolumebetweenthetwogroups．Significant differencewasf0undin1minand5rainApgarscorebetweenCSA andGA groups．Bloodpressurebegantodeclineafteranesthesiain twogroups，butthereweresignificantdifferencesbetweenthetwogroups．Thedeclinedrateofbloodpressureat10minuteinCSAgroup waslowerthanthatinGA group．Conclusions Continuousspinalanesthesiacanbesecurelyappliedtocesareansectionofpatients withpregnancycombinedwiththrombocytopenia． Keywords：continuousspinalanesthesia(CSA)；pregnancyassociatedthrombocytopenia(PAT)；cesareansection 对于妊娠合并血小板减少症产妇剖宫产术麻醉方法的 例。随机分为两组，连续腰麻组c组29例 ，全麻组 G组23 选择一直是麻醉科医师关注的焦点。