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[子痫前期与麻醉]

[Pre-eclampsia and anesthesia].

作者信息

Grau T, Conradi R, Wacker J, Martin E

机构信息

Klinik für Anästhesiologie, Universitätsklinikum Heidelberg.

出版信息

Zentralbl Gynakol. 1999;121(12):627-30.

Abstract

The management of anaesthesia in patients suffering preeclampsia has to be selected individually. There is a high rate of caesarean sections in patients with preeclampsia. Intubation anaesthesia or regional anaesthesia are commonly used methods and can be considered comparable and equally useful. In our opinion, the application of regional anaesthesia should be preferred, if the initial criteria, such as normal neurologic status and blood coagulation, are fulfilled. We believe in a considerable reduction of vital risks when using regional anaesthesia. Our aim was to figure out the risk-factors of preeclampsia and preterm maturity regarding anaesthesia management. Preeclampsia is a severe illness in pregnancy with a frequency of 5-10%. In 1997, we experienced 73 patients with praeeclampsia according to the definition of ISSPH. Mode of delivery was conventional in 10 patients, 2 patients had a vacuum extraction and 61 patients needed a caesarean section. The rate of epidural anesthesia for delivery was 51%. We used epidural anaesthesia in 6 spontaneous deliveries, in 2 vacuum extractions and in 30 caesarean sections. There were no problems with epidural anaesthesia and the outcome of mother and child was also considered to be excellent. We suggest to use regional anesthesia techniques whenever possible.

摘要

子痫前期患者的麻醉管理必须个体化选择。子痫前期患者剖宫产率较高。气管插管麻醉或区域麻醉是常用方法,可认为二者具有可比性且同样有效。我们认为,如果满足初始标准,如神经状态正常和凝血功能正常,应优先应用区域麻醉。我们相信使用区域麻醉时重大风险会显著降低。我们的目的是找出子痫前期和早产在麻醉管理方面的风险因素。子痫前期是一种严重的妊娠疾病,发病率为5% - 10%。1997年,根据国际妊娠高血压研究学会(ISSPH)的定义,我们收治了73例子痫前期患者。10例患者采用传统分娩方式,2例患者采用真空吸引助产,61例患者需要剖宫产。分娩时硬膜外麻醉率为51%。我们在6例自然分娩、2例真空吸引助产和30例剖宫产中使用了硬膜外麻醉。硬膜外麻醉未出现问题,母婴结局也被认为非常好。我们建议尽可能使用区域麻醉技术。

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