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[子痫前期和子痫产妇的麻醉管理]

[Anesthetic management of parturients with pre-eclampsia and eclampsia].

作者信息

Fetsch N I, Bremerich D H

机构信息

Klinik für Anästhesiologie, Ludwig-Maximilians-Universität, Klinikum Innenstadt, München, Deutschland.

出版信息

Anaesthesist. 2008 Jan;57(1):87-102. doi: 10.1007/s00101-007-1302-x.

Abstract

Preeclampsia is a pregnancy-associated illness affecting multiple organ systems. Symptoms typically occur after the 20th week of gestation and consist of hypertension (>140/90 mmHg) and proteinuria (>300 mg/day). It is one of the leading causes of premature birth worldwide and early diagnosis and treatment are essential for both fetal and maternal health. Therapy is aimed at lowering blood pressure sufficiently to prevent the most severe complications such as intracranial hemorrhages. At the same time attention must be paid to the possible untoward effects of blood pressure medications on uteroplacental perfusion and fetal well being. Magnesium is the cornerstone for both prevention and control of eclamptic cerebrovascular events. In cases of severe preeclampsia and eclampsia prompt delivery is indicated, often carried out by Cesarean section (>34 weeks of gestation). Compared to general anesthesia, regional anesthesia techniques offer certain advantages to both mother and fetus and in the absence of contraindications are the methods of choice.

摘要

子痫前期是一种与妊娠相关的疾病,会影响多个器官系统。症状通常在妊娠20周后出现,包括高血压(>140/90 mmHg)和蛋白尿(>300 mg/天)。它是全球早产的主要原因之一,早期诊断和治疗对胎儿和母亲的健康都至关重要。治疗旨在充分降低血压,以预防最严重的并发症,如颅内出血。同时,必须注意血压药物对子宫胎盘灌注和胎儿健康可能产生的不良影响。镁是预防和控制子痫性脑血管事件的基石。在重度子痫前期和子痫的情况下,建议及时分娩,通常通过剖宫产(妊娠>34周)进行。与全身麻醉相比,区域麻醉技术对母亲和胎儿都有一定优势,在没有禁忌证的情况下是首选方法。

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