首頁資訊前置胎盤患者剖宮產(chǎn)術(shù)中的麻醉管理:一項回顧性隊列研究

前置胎盤患者剖宮產(chǎn)術(shù)中的麻醉管理:一項回顧性隊列研究

來源：泰然健康網(wǎng) 時間：2024年11月23日 22:22

本文由“罌粟花”授權(quán)轉(zhuǎn)載

前置胎盤患者剖宮產(chǎn)術(shù)中的麻醉管理:一項回顧性隊列研究

81721639436716212

貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組

翻譯：張中偉編輯：張中偉審核：曹瑩

背景

前置胎盤的發(fā)病率正在持續(xù)上升。我們認(rèn)為剖宮產(chǎn)是前置胎盤產(chǎn)婦妊娠的唯一安全并合適的分娩方式。麻醉管理在剖宮產(chǎn)術(shù)中非常重要。本研究的目的是比較在剖宮產(chǎn)術(shù)中使用椎管內(nèi)麻醉的前置胎盤產(chǎn)婦與使用全身麻醉的前置胎盤產(chǎn)婦的結(jié)局及新生兒的健康情況。

方法

從2014年1月1日至2019年6月30日，在我們的大型學(xué)術(shù)機(jī)構(gòu)對所有前置胎盤患者進(jìn)行了回顧性隊列研究。患者在剖宮產(chǎn)術(shù)中接受椎管內(nèi)麻醉或全身麻醉。

結(jié)果

本研究納入了1234例確診為前置胎盤的患者，并于本醫(yī)療機(jī)構(gòu)接受剖宮產(chǎn)術(shù)。737例(59.7%)患者進(jìn)行了椎管內(nèi)麻醉，497例(40.3%)患者進(jìn)行了全身麻醉。椎管內(nèi)麻醉組的平均預(yù)計失血量為558.96±42.77毫升，明顯低于全身麻醉組的預(yù)計失血量1952.51±180毫升(p < 0.001)。737名患者中有146名(19.8%)在椎管內(nèi)麻醉時需要輸血，而497名患者中有381名(76.7%)在全身麻醉時需要輸血。椎管內(nèi)麻醉下新生兒窒息率和NICU入院率明顯低于全身麻醉(分別為2.7%對19.5%和18.2%對44.1%)。排除干擾因素后進(jìn)行對比，椎管內(nèi)麻醉組患者失血量較少，1分鐘和5分鐘的Apgar評分較高，輸血率、新生兒窒息率和NICU入院率較低。

97521639436717338

結(jié)論

我們的數(shù)據(jù)表明，在剖宮產(chǎn)術(shù)中接受椎管內(nèi)麻醉可以為前置胎盤產(chǎn)婦和新生兒帶來更好的結(jié)局。

原始文獻(xiàn)來源： Dazhi Fan, Jiaming Rao, Dongxin Lin, et al. Anesthetic management in cesarean delivery of women with placenta previa: a retrospective cohort study.[J]. BMC Anesthesiol (2021) 21:247 :1

英文原文

Anesthetic management in cesarean

delivery of women with placenta previa:

a retrospective cohort study

Background: The incidence of placenta preiva is rising. Cesarean delivery is identified as the only safe and appropriate mode of delivery for pregnancies with placenta previa. Anesthesia is important during the cesarean delivery.

The aim of this study is to assess maternal and neonatal outcomes of patients with placenta previa managed with neuraxial anesthesia as compared to those who underwent general anesthesia during cesarean delivery.

Method:A retrospective cohort study was performed of all patients with placenta preiva at our large academic institution from January 1, 2014 to June 30, 2019. Patients were managed neuraxial anesthesia and general anesthesia during cesarean delivery.

Results:We identified 1234 patients with placenta previa who underwent cesarean delivery at our institution. Neuraxial anesthesia was performed in 737 (59.7%), and general anesthesia was completed in 497 (40.3%) patients. The mean estimated blood loss at neuraxial anesthesia of 558.96 ± 42.77 ml were significantly lower than the estimated blood loss at general anesthesia of 1952.51 ± 180 ml (p < 0.001). One hundred and forty-six of 737 (19.8%) patients required blood transfusion at neuraxial anesthesia, whereas 381 out of 497 (76.7%) patients required blood transfusion at general anesthesia. The rate neonatal asphyxia and admission to NICU at neuraxial anesthesia was significantly lower than general anesthesia (2.7% vs. 19.5 and 18.2% vs. 44.1%, respectively). After adjusting confounding factors, blood loss was less, Apgar score at 1- and 5-min were higher, and the rate of blood transfusion, neonatal asphyxia, and admission to NICU were lower in the neuraxial group.

Conclusion:Our data demonstrated that neuraxial anesthesia is associated with better maternal and neonatal outcomes during cesarean delivery in women with placenta previa.

END

本文由“健康號”用戶上傳、授權(quán)發(fā)布，以上內(nèi)容（含文字、圖片、視頻）不代表健康界立場?！敖】堤枴毕敌畔l(fā)布平臺，僅提供信息存儲服務(wù)，如有轉(zhuǎn)載、侵權(quán)等任何問題，請聯(lián)系健康界（jkh@hmkx.cn）處理。

關(guān)鍵詞:

previa,blood,剖宮產(chǎn)術(shù),NICU,回顧性,新生兒,胎盤,患者,麻醉,前置,管理,椎管

網(wǎng)址: 前置胎盤患者剖宮產(chǎn)術(shù)中的麻醉管理:一項回顧性隊列研究 http://www.u1s5d6.cn/newsview40511.html