钢丝加强硬膜外导管在剖宫产麻醉中的应用效果

    The application effect of wire-reinforced epidural catheter during the anesthesia period of cesarean section

    • 摘要: 目的:观察钢丝加强硬膜外导管在剖宫产麻醉中的应用效果。方法:腰硬联合麻醉下行剖宫产术,且要求硬膜外术后镇痛的产妇400例,采取随机数字表法分为普通硬膜外导管组(A组)和钢丝加强硬膜外导管组(B组),各200例。常规行腰硬联合阻滞操作,2组置入相应的硬膜外导管。观察置管困难、置管异感、回抽见血、脑脊液,注药遇阻,拔管困难,拔管时导管被拉长,拔管后出血的发生率。记录术后镇痛期间穿刺部位不适程度及发生率。结果:B组置管困难、置管异感、回抽见血、注药遇阻、导管被拉长和拔管后出血发生率均低于A组(P < 0.05~P < 0.01)。B组患者术后镇痛期间穿刺部位不适发生率明显高于A组(P < 0.01)。2组患者未发生导管打折,误入蛛网膜下腔或发生硬膜外血肿。结论:钢丝加强硬膜外导管在剖宫产术中安全性优于普通硬膜外导管,但预留的导管可引起穿刺部位术后疼痛不适。

       

      Abstract: Objective: To observe the application effects of wire-reinforced epidural catheter during the anesthesia period of cesarean section.Methods: Four hundred pregnancy women treated with cesarean section under combined spinal and epidural anesthesia were randomly divided into the ordinary epidural catheter group(group A) and wire-reinforced epidural catheter group(group B) according to the digital table method(200 cases each group).The two groups were treated with combined spinal-epidural anesthesia(CSEA),and intubated the corresponding epidural catheter.Results: The incidences of the catheter difficulty,paresthesia,bleeding withdraw,prolonging catheter and bleeding after extubating in group B were lower than those in group A(P < 0.05 to P < 0.01).The incidence of the discomfort in puncture location during postoperative analgesia in group B was significantly higher than that in group A(P < 0.01).The catheter discount,straying the subarachnoid or epidural hematoma were found in two groups.Conclusions: The safety of wire-reinforced epidural catheter during the cesarean section period is better than that in ordinary epidural catheter,but which can lead to pain discomfort in catheter reserved location.

       

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