方军,王胜斌
FANG Jun,WANG Shengbin

• 1:安徽医科大学附属安庆医院麻醉科

摘要(Abstract)：

目的:比较腰椎固定间隙(L3-4)不同入路单次腰麻用于剖宫产术的临床效果。方法:90例行剖宫产术产妇,随机均分为3组,均选择从L3-4间隙入路;A组为25G细针正中入路直刺法(细针与脊柱垂直入路),B组为25G细针正中入路斜刺法(针尾向骶尾端,细针与脊柱成75°夹角),C组为传统针内针与脊柱垂直穿刺入路;对3组患者的麻醉时间、穿刺时间、不良反应以及术后随访情况进行比较。结果:B组和C组麻醉效果明显优于A组(P<0.05);A组术中疼痛,牵拉反应明显高于其他两组(P<0.05),C组穿刺时间明显长于A组与B组(P<0.05);术后随访中,头痛发生率各组比较差异无统计学意义(P>0.05),腰痛发生率C组明显高于A组和B组(P<0.05),各组均未出现下肢痛症状。结论:L3-4间隙25G细针直入法与脊柱倾斜入路,穿刺方便,麻醉效果确切,不良反应与术后并发症少。
Objective: To investigate the clinical effect of single spinal anesthesia by different approaches through L3-4interval in treatment of cesarean section. Methods: Ninety cases of cesarean section were randomly divided into 3 groups,30 cases in each group. In group A: 25 G fine needle was used by vertical approach; In group B: 25 G fine needle was used by inclined approach( the needle tail pointing to the sacral and fine needle forming 75 degree angle with spine); In group C: ordinary acupuncture was used by acupuncture approach. Then the anesthesia duration,puncture time,adverse reaction and postoperative follow-up survey were compared between group A,B and C. Results: Compared with group B and group C,the anesthetic effect of group A was significantly better( P < 0. 05).The pain and stretch reaction in group A were significantly stronger than those in group B and group C( P < 0. 05). The puncture time in group C was significantly longer than that in group A and group B( P < 0. 05). In postoperative follow-up,there were no statistical differences in the incidence of headache( P > 0. 05). The incidence of lumbago in group C was significantly higher than its counterparts in group A and group C. There appeared no lower limb pain in each group. Conclusion: In spinal anesthesia through the interval( L3-4),the 25 G fine needle by inclined approach is convenient in cesarean section,which shows its certain analgesic effect,less adverse reaction and less complication.

关键词(KeyWords)： 剖宫产术;细针;腰椎麻醉
cesarean section;fine needle;spinal anesthesia

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 方军,王胜斌
FANG Jun,WANG Shengbin

DOI: 10.19367/j.cnki.1000-2707.2015.10.039

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