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目的探讨剖宫产中应用腰-硬联合阻滞、硬膜外阻滞、蛛网膜下腔阻滞的临床效果,获取最佳麻醉方式。方法选取2012年1月至2014年5月我院接诊剖宫产产妇151例,随机分为腰-硬组51例、硬膜组50例、下腔组50例。其中腰-硬组产妇给予腰-硬联合麻醉处理,硬膜组产妇给予硬膜外麻醉处理,下腔组产妇给予蛛网膜下腔麻醉处理;观察记录麻醉前、麻醉后3组产妇的血压与心率情况,以及3组产妇麻醉起效时间、阻滞效果、牵拉反应和新生儿Apgar评分情况。结果 3组产妇的麻醉起效时间、阻滞效果、牵拉反应及术后并发症等比较,腰-硬联合阻滞运用于剖宫产临床效果明显优于硬膜外阻滞及蛛网膜下腔阻滞,差异有统计学意义(P<0.05);3组新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论在剖宫产手术中运用腰-硬联合阻滞的总体麻醉效果更好。
Objective To investigate the clinical effect of applying combined spinal-epidural block, epidural block and subarachnoid block in cesarean section and to obtain the best anesthetic mode. Methods From January 2012 to May 2014, 151 cases of postpartum cesarean delivery in our hospital were randomly divided into waist-hard group (n = 51), epidural group (n = 50) and inferior-group group (n = 50). The patients in the lumbar-hard group were given combined spinal-epidural anesthesia, the epidural anesthesia was given in the epidural group and the subarachnoid anesthesia in the inferior group. The blood pressure Heart rate, and onset time of anesthesia in 3 groups, blocking effect, stretching reaction and neonatal Apgar score. Results Compared with the onset time of anesthesia, the blocking effect, the pulling reaction and postoperative complications in the 3 groups, the clinical effect of combined lumbar-hard block in cesarean section was better than that of the epidural block and subarachnoid block (P <0.05). There was no significant difference in Apgar score between the three groups (P> 0.05). Conclusions The overall anesthesia using a combination of waist-hard block in caesarean section is better.