体表标志定位与超声引导定位在剖宫产产妇麻醉中的应用效果

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摘要目的比较体表标志定位与超声引导定位在剖宫产产妇麻醉中的应用效果。方法选取2015年1月～2016年12月在我院行剖宫产分娩的80例产妇，均采用腰硬联合麻醉，采用随机数字表法将入选患者分为体表组与超声组，各40例。体表组采用传统体表定位进行穿刺，超声组则在超声成像引导下进行穿刺定位，比较两组的麻醉前定位时间、穿刺次数及改硬膜外麻醉例数，统计两组的麻醉相关并发症发生率。结果超声组的麻醉前定位时间长于体表组，首次穿刺成功率显著高于体表组，差异有统计学意义（P＜0.05）。两组的改硬膜外麻醉例数所占比例比较，差异无统计学意义（P＞0.05）。超声组的置管出血、神经刺激征象、下肢感觉异常、术后腰痛等并发症发生率均显著低于体表组，差异有统计学意义（P＜0.05）。结论超声引导定位用于剖宫产产妇的腰硬联合麻醉能够有效提高穿刺成功率，减少麻醉相关并发症的发生，值得临床推广应用。

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	麦亚强
	温金鸿

关键词 ：剖宫产, 体表定位, 超声定位, 腰硬联合麻醉, 并发症

Abstract：ObjectiveTo compare the application effect of body surface marking localization and ultrasound-guided localization in parturients anesthesia of cesarean section.MethodsFrom January 2015 to December 2016,80 parturients who underwent cesarean section in our hospital were selected and given spinal epidural anesthesia.The patients were divided into the body surface group and the ultrasonic group by random number table method,40 cases in each group.The surface group was punctured by traditional body surface location,while the ultrasound group was punctured by ultrasound-guided.The localization time of pre-anesthesia,the number of times of puncture and the number of epidural anesthesia were compared between the two groups,and the incidence rate of anesthesia related complications in the two groups was counted.ResultsThe localization time of pre-anesthesia in the ultrasound group was longer than that in the surface group,and the successful rate of first puncture in the ultrasound group was higher than that of surface group,with significant difference(P＜0.05).There was no significant difference in the proportion of epidural anesthesia between the two groups(P＞0.05).The incidence rate of complications such as catheter bleeding,nerve stimulation signs,paresthesia of the lower extremities and postoperative low back pain in the ultrasound group was significantly lower than that in the surface group,with significant difference (P＜0.05).ConclusionUltrasound-guided localization of lumbar-epidural anesthesia for cesarean section can effectively improve the success rate of puncture and reduce the incidence rate of anesthesia-related complications.It is worthy of clinical promotion and application.

Key words： Cesarean section Body surface location Ultrasound positioning Combined spinal epidural anesthesia Complication

作者简介: 麦亚强（1976-），男，广东湛江人，本科，副主任医师，主要从事超声麻醉方向的研究

引用本文:

麦亚强;温金鸿. 体表标志定位与超声引导定位在剖宫产产妇麻醉中的应用效果[J]. 中国当代医药, 2017, 24(20): 128-130.
MAI Ya-qiang;WEN Jin-hong. Application effect of body surface marking localization and ultrasoundguided localization in parturients anesthesia of cesarean section. 中国当代医药, 2017, 24(20): 128-130.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I20/128

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