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目的探讨重度子痫前期剖宫产麻醉选择及围术期管理,减少母婴的死亡率。方法对子痫前期58例依病情、麻醉药及方法、禁忌证随机分为连硬外阻滞27例、静脉复合麻醉11例、腰硬联合麻醉13例、局麻M1 7例。结果 58例麻醉后血压变化与麻醉方法经统计学处理存在统计学差异(P<0.05)。术中无一例血压升高,无术中死亡。术后随访,2例于术后2~4 d死于脑水肿、脑疝、心肾衰竭。结论连硬外阻滞组、腰硬联合麻醉组具有用药量少、作用快、手术部位肌肉松弛,循环稳定,无并发症发生,适用于重度子痫前期剖宫产术的麻醉。
Objective To investigate the choice of cesarean section anesthesia and management of perioperative period in severe preeclampsia to reduce maternal and infant mortality. Methods 58 cases of preeclampsia according to illness, anesthetics and methods, contraindications were randomly divided into even with 27 cases of hard block, intravenous anesthesia in 11 cases, 13 cases of combined spinal and spinal anesthesia, local anesthesia M1 7 cases. Results 58 cases of post-anesthesia blood pressure and anesthesia methods were statistically significant (P <0.05). No intraoperative blood pressure, no intraoperative death. Postoperative follow-up, 2 patients died of cerebral edema 2 ~ 4 d after surgery, hernia, heart failure. Conclusions Even combined with external hysteresis block and combined spinal and epidural anesthesia, it is suitable for anesthesia of cesarean section in severe preeclampsia with less dosage, fast acting, muscle relaxation in the operation site, stable circulation and no complication.