严长亭 郭俊红

[摘要] 目的 探討喉罩下七氟醚吸入全身麻醉与椎管内麻醉在剖宫产术中的对比效果。 方法 该研究方便选择2015年5月—2017年5月期间聊城东昌府区妇幼保健院收治的剖宫产产妇120例，采用随机数字表的方法分组，其中60例作为观察组采用喉罩下七氟醚吸入全身麻醉，60例作为对照组选用椎管内麻醉，记录并且统计两组产妇的产妇术中血压波动、心率波动及血氧波动，出生即刻、5 min、10 min的新生儿Apgar 评分，产妇并发症和满意度。 结果 观察组产妇术中收缩压波动、舒张压波动、心率波动及血氧波动分别为（14.73±3.89）mmHg 、8.85±2.39）mmHg、（8.69±1.48）次/min、（7.59±1.08）%，均低于对照组产妇（26.94±6.57）mmHg、（17.48±4.39）mmHg、（19.75±1.93）次/min、（3.29±0.73）%，血流动力学更加平稳，差异有统计学意义（P<0.05）。观察组新生儿出生即刻、5 min、10 min的 Apgar 评分分别为（7.73±0.89）分、（8.15±4.39）分、（8.69±1.48）分，与对照组新生儿评分（7.94±1.57）分、（8.87±5.39）分、（9.05±1.53）分相比，差异无统计学意义（P>0.05）。 结论 喉罩下七氟醚吸入全身麻醉与椎管内麻醉相比，在剖宫产术中的麻醉效果满意，并且有一定优势，值得在合适的产妇麻醉中应用。

[关键词] 喉罩下；七氟醚吸入；全身麻醉；椎管内麻醉；剖宫产

[中图分类号] R726 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0026-03

Comparative Study of Sevoflurane Inhalation General Anesthesia and Spinal Anesthesia under Laryngeal Mask in Cesarean Section

YAN Chang-ting1， GUO Jun-hong2

1.Department of Anesthesiology，Liaocheng Dongchangfu Maternal and Child Health Care Hospital， Guanxian， Shandong Province， 252000 China； 2.General Practice， Liaocheng Dongchangfu Maternal and Child Health Care Hospital， Guanxian， Shandong Province， 252000 China

[Abstract] Objective This paper tries to compare the effect of sevoflurane inhalation anesthesia under laryngeal mask and general anesthesia in cesarean section. Methods 120 cases of cesarean section in this hospital were convenient selected from May 2015 to May 2017， by using the method of random number table， 60 cases treated with laryngeal mask inhalation of sevoflurane anesthesia， 60 cases as control group with spinal anesthesia， and the maternal intraoperative blood pressure fluctuation， the fluctuation of heart rate and blood oxygen fluctuation， birth moment， 5 minutes， 10 minutes of neonatal Apgar the maternal complications and satisfaction scores were compared. Results The observation group maternal systolic blood pressure， diastolic blood pressure fluctuations， heart rate fluctuations and blood oxygen fluctuations were（14.73±3.89）mmHg，（8.85±2.39）mmHg，（8.69±1.48）times/min，（7.59±1.08）%， were lower than the control group of maternal（26.94±6.57）mmHg，（17.48±4.39）mmHg， （19.75±1.93）times/min， （3.29±0.73）% respectively. The hemodynamics was more stable with statistical significance（P<0.05）. The newborns in the observation group were （7.73±0.89）points， （8.15±4.39）points and（8.69±1.48）points respectively at 5 min and 10 min after birth， compared with the newborns in the control group（7.94±1.57）points，（8.87±5.39）points， and （95.05±1.53）points Statistical difference（P>0.05）. Conclusion Sevoflurane Inhalation Anesthesia with laryngeal mask airway is better than anesthesia with spinal anesthesia in cesarean section， and it has some advantages and is worthy of application in appropriate maternal anesthesia.

[Key words] Laryngeal mask airway； Sevoflurane inhalation； General anesthesia； Spinal anesthesia； Cesarean section

随着国家二胎政策的放开，医院迎来了一波生育高峰[1]。剖宫产手术是医院手术室内的常规手术，相应的剖宫产麻醉是手术室麻醉医师经常面对的问题[2]。现在医院对剖宫产常用的麻醉方式是椎管内麻醉[3]。对于有椎管内麻醉有禁忌症的产妇需要选择全身麻醉，但是全麻药物对产妇和胎儿会产生不良影响，因为呼吸抑制会导致产妇低氧血症，影响了胎儿的生命安全[4]。因此麻醉师在选择剖宫产手术的麻醉时应慎重选择药物的种类和用药途径[5]。……