Keleş Esengül, Yazgan Hamza, Gebeşçe Arzu, Pakır Emine
Department of Pediatrics, Fatih University, Turkey.
ISRN Pediatr. 2013 Apr 24;2013:264340. doi: 10.1155/2013/264340. Print 2013.
Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (P < 0.05) (odds ratio = 1.471 and 95%CI: 0.92-2.35). Conclusions. The incidence of TTN was found related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions.
目的。探讨剖宫产术中接受全身麻醉或硬膜外-脊髓联合麻醉(CES)的女性中,新生儿短暂性呼吸急促(TTN)的发生率是否更高。方法。本研究为回顾性研究。2008年1月至2011年12月期间,我院共进行了1447例剖宫产手术(C/S)。其中1078例(74.5%)剖宫产病例采用全身麻醉,369例(25.5%)采用CES麻醉。采用国际疾病分类第十版P22.1编码来识别患有TTN的婴儿。对亚组进行分层多变量分析,以评估已知影响TTN发生率的因素的效应修正:产妇年龄、产妇收缩压-舒张压、心率、1分钟和5分钟时的阿氏评分、性别、从脊髓阻滞到皮肤切开的时间间隔以及从皮肤切开到脐带结扎的时间间隔。结果。发现剖宫产时采用硬膜外-脊髓联合麻醉的产妇中TTN诊断率较高,但未发现统计学差异(P<0.05)(优势比=1.471,95%可信区间:0.92-2.35)。结论。发现TTN的发生率与剖宫产有关,但与麻醉类型无关。然而,需要对更广泛的患者群体进行研究,且组间定量差异更小,以便得出确凿的结论。