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目的观察腰硬联合麻醉(CSEA)应用于妊高征产妇剖宫产术的安全性及临床效果。方法对109例妊高征剖宫产产妇随机分为腰硬联合麻醉组(CSEA组)57例和硬膜外麻醉组(EA组)52例。比较两组麻醉起效时间、麻醉阻滞效果、新生儿Apgar评分及不良反应。结果 2组麻醉起效时间、达最高阻滞平面时间及切皮至胎儿娩出时间分别比较,差异均有统计学意义(P均<0.05);2组麻醉效果的优良率比较,差异有统计学意义(P<0.05);两组新生儿1min和5min Apgar评分差异均无统计学意义(P均>0.05);2组患者不良反应发生率差异无统计学意义(P>0.05)。结论 CSEA具有用药量少、起效快、镇痛完全、阻滞完善、肌松满意、对循环、呼吸干扰小、并发症少、不受时间限制及对母婴安全等优点,用于妊高征产妇剖宫产术安全可行。
Objective To observe the safety and clinical effect of combined spinal and epidural anesthesia (CSEA) on cesarean section in pregnant women with PIH. Methods 109 pregnant women with PIH were randomly divided into 57 cases of CSEA group and 52 cases of EA group (epidural anesthesia group). The onset of anesthesia, anesthesia block, neonatal Apgar score and adverse reactions were compared between the two groups. Results The onset time of anesthesia, the time of reaching the maximal block level and the time from skin incision to fetus delivery in the two groups were significantly different (all P <0.05). There was statistically significant difference in the excellent and good rates of anesthesia between the two groups (P <0.05). There was no significant difference in Apgar scores at 1 minute and 5 minutes between the two groups (all P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions CSEA has the advantages of less dosage, fast onset of action, complete analgesia, complete block, satisfactory muscle relaxation, less circulation, less respiratory disturbance, less complications, no time limit and safety for mother and baby, Cesarean section is safe and feasible.