全凭静脉麻醉对重度子痫前期产妇ONSD、血流动力学及新生儿的影响
Effects of Total Intravenous Anesthesia on ONSD,Hemodynamics and Ne-onates in Puerperas with Severe Preeclampsia
詹夏娟 1肖永涛 1文乔兴 1董蜀华2
作者信息
- 1. 625100 四川 雅安,成都医学院第一附属医院名山分院麻醉科
- 2. 610599 成都,成都医学院第一附属医院麻醉科
- 折叠
摘要
目的 探讨全凭静脉麻醉对重度子痫前期产妇视神经鞘直径(ONSD)、血流动力学及新生儿的影响.方法 选择2019 年11 月—2022 年7 月收治重度子痫前期产妇108 例,按照麻醉方式不同分为观察组56 例和对照组52 例.观察组采用全凭静脉麻醉,对照组采用硬膜外麻醉.对比 2 组手术相关指标、ONSD、血流动力学[收缩压(SBP)、舒张压(DBP)、MAP、心率]及新生儿Apgar评分、插管率.结果 观察组麻醉诱导时间、胎儿娩出时间均短于对照组(P＜0.01).观察组麻醉后5 min、胎儿娩出后5 min、术毕30 min ONSD小于麻醉前和对照组(P＜0.05);观察组术毕30 min DBP高于对照组,麻醉后5 min、胎儿娩出后5 min、术毕30 min心率快于对照组(P＜0.05).观察组新生儿5 min Apgar评分高于对照组(P＜0.01).观察组新生儿插管率(8.92%,5/56)与对照组(11.53%,6/52)比较差异无统计学意义(P＞0.05).结论 全凭静脉麻醉较硬膜外麻醉有利于改善重度子痫前期产妇ONSD,可显著降低产妇颅内压,且对血流动力学及新生儿影响更小.
Abstract
Objective To analyze the effects of total intravenous anesthesia(TIVA)on optic nerve sheath diameter(ONSD),hemodynamics and neonates in puerperas with severe preeclampsia.Methods A total of 108 pregnant women with severe preeclampsia treated from November 2019 to July 2022 were selected and divided into observation group(n =56)and control group(n =52)according to different anesthesia methods.The observation group was given TIVA,and the control group was given epidural anesthesia.Operation-related indicators,ONSD,hemodynamics[systolic blood pressure(SBP),di-astolic blood pressure(DBP),mean arterial pressure(MAP),heart rate],neonatal Apgar score and neonatal intubation rate were compared between the two groups.Results The time of anesthesia induction and fetal delivery in the observation group was shorter than that in the control group(P＜0.01).In observation group,ONSD at 5 min after anesthesia,at 5 min after delivery and at 30 min after operation were lower than those before anesthesia and those in control group(P＜0.05).DBP was higher at 30 min after operation in observation group than in control group,and HR at 5 min after anesthesia,at 5 min af-ter delivery and at 30 min after operation was faster than those in control group(P＜0.05).The 5 min Apgar score of the ob-servation group was higher than that of the control group(P＜0.01).There was no significant difference in the intubation rate of neonates between the observation group and the control group[(8.92%,5/56)vs.(11.53%,6/52)](P＞0.05).Conclusion Compared with epidural anesthesia,TIVA can improve ONSD of puerperas with severe preeclampsia,signifi-cantly reduce intracranial pressure,and have fewer effects on hemodynamics and neonates.
关键词
全凭静脉麻醉/硬膜外麻醉/子痫前期/视神经鞘直径/血流动力学/颅内压/婴儿,新生/Apgar评分Key words
Total intravenous anesthesia/Epidural anesthesia/Severe preeclampsia/Optic nerve sheath diameter/Hemodynamics/Intracranial pressure/Infant,newborn/Apgar score引用本文复制引用
基金项目
四川省科学技术厅计划项目(2020YJ0391)
出版年
2023
国家科技期刊平台
NSTL
万方数据