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剖宫产术后出血的麻醉管理危险因素。

Anesthetic management as a risk factor for postpartum hemorrhage after cesarean deliveries.

机构信息

Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan.

出版信息

Am J Obstet Gynecol. 2011 Nov;205(5):462.e1-7. doi: 10.1016/j.ajog.2011.06.068. Epub 2011 Jun 25.

Abstract

OBJECTIVE

This population-based study aimed to compare the risk of postpartum hemorrhage (PPH) for patients who underwent cesarean section delivery (CS) with general vs spinal/epidural anesthesia.

STUDY DESIGN

We identified 67,328 women who had live singleton births by CS by linking the Taiwan National Health Insurance Research Dataset and the national birth certificate registry. Multivariate logistic regression was carried out to explore the relationship between anesthetic management type and PPH.

RESULTS

Women who received general anesthesia had a higher rate of PPH than women who received epidural anesthesia (5.1% vs 0.4%). The odds of PPH in women who had CS with general anesthesia were 8.15 times higher (95% confidence interval, 6.43-10.33) than for those who had CS with epidural anesthesia, after adjustment was made for the maternal and fetal characteristics.

CONCLUSION

The odds that women will experience cesarean PPH with general anesthesia are approximately 8.15 times higher than for women who undergo CS with epidural anesthesia.

摘要

目的

本基于人群的研究旨在比较行剖宫产术(CS)的患者接受全身麻醉与椎管内麻醉(脊髓/硬膜外麻醉)后发生产后出血(PPH)的风险。

研究设计

我们通过链接台湾全民健康保险研究数据集和全国出生证明登记处,确定了 67328 名接受 CS 的活单胎分娩的女性。采用多变量逻辑回归来探讨麻醉管理类型与 PPH 之间的关系。

结果

接受全身麻醉的女性发生产后出血的比例高于接受硬膜外麻醉的女性(5.1% vs 0.4%)。调整产妇和胎儿特征后,接受全身麻醉 CS 的女性发生产后出血的几率是接受硬膜外麻醉 CS 的女性的 8.15 倍(95%置信区间,6.43-10.33)。

结论

与接受硬膜外麻醉 CS 的女性相比,接受全身麻醉 CS 的女性发生产后出血的几率大约高 8.15 倍。

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