剖宫产术中小腿加压对脊髓麻醉后低血压及新生儿血流动力学参数的影响：非随机对照临床试验

Effect of lower leg compression during cesarean section on post-spinal hypotension and neonatal hemodynamic parameters: nonrandomized controlled clinical trial.

作者信息

Ebrahim Elgzar Wafaa Taha, Ebrahim Said Hanan, Ebrahim Heba Abdelfatah

机构信息

Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, University of Damanhour, Egypt.

Department of Obstetrics and Woman Health Nursing, Faculty of Nursing, University of Benha, Egypt.

出版信息

Int J Nurs Sci. 2019 Jun 10;6(3):252-258. doi: 10.1016/j.ijnss.2019.06.003. eCollection 2019 Jul 10.

DOI:10.1016/j.ijnss.2019.06.003

PMID:31508443

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6722476/

Abstract

OBJECTIVES

This study aimed to determine the effect of lower leg compression during cesarean section (CS) on post-spinal hypotension (PSH) and neonatal hemodynamic parameters.

METHODS

This study is a nonrandomized controlled clinical trial conducted in the cesarean delivery unit of the National Medical institute, Damanhour, Egypt. The sample included 120 parturients (60 intervention and 60 control). The researchers developed three tools for data collection: sociodemographic data and reproductive history interview schedule, electronic monitoring of maternal hemodynamic parameters, and neonatal hemodynamic assessment sheet. All parturients received ordinary pre-operative care. For the intervention group, a long elastic stocking (ordinary pressure 20-30 mmHg, 1 mmHg = 0.133 kPa) was applied on both legs during cesarean section. The control group received the same care without the elastic stocking.

RESULTS

Systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were significantly higher in the intervention group throughout the entire operation period except in the last 5-15 min. Heart rate was significantly lower in the intervention group. Only 13.3% of the intervention group took ephedrine compared with 45% of the control group. Apgar score was higher among neonates of intervention group compared with the control group at 1 min. Neonatal acidosis was significantly higher in the control group than in the contral group.

CONCLUSION

Lower leg compression technique can effectively reduce PSH and neonatal acidosis.

摘要

目的

本研究旨在确定剖宫产术中下肢加压对脊髓麻醉后低血压（PSH）及新生儿血流动力学参数的影响。

方法

本研究是在埃及达曼胡尔国家医学研究所剖宫产科室进行的一项非随机对照临床试验。样本包括120名产妇（60名干预组和60名对照组）。研究人员开发了三种数据收集工具：社会人口统计学数据和生殖史访谈表、产妇血流动力学参数电子监测以及新生儿血流动力学评估表。所有产妇均接受常规术前护理。干预组在剖宫产术中双腿应用长筒弹力袜（常压20 - 30 mmHg，1 mmHg = 0.133 kPa）。对照组接受相同护理但不使用弹力袜。