细针单独穿刺手法在剖宫产腰麻中的应用

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目的:探讨细针单独穿刺手法在剖宫产手术腰麻中应用的优、缺点。方法:1 220例剖宫产产妇随机分成腰硬联合穿刺组(A组)、细针单独穿刺组(B组)各610例。比较两组在一次穿刺成功、穿刺疼痛、穿破硬膜、置管并发症(误入血管、导管不入、异感)等方面差别,术后第1天(T1)、第2天(T2)、第3~5天(T3)、第7天(T7)随访观察穿刺部位红、触痛。结果:A、B两组一次穿刺成功率差异无统计学意义(P>0.05),穿刺疼痛有统计学意义(P<0.05),穿破硬膜、置管并发症B组无,穿刺部位红、触痛术后T1、T2两组差异有统计学意义(P<0.05),术后T3、T7差异无统计学意义(P>0.05)。结论:细针单独穿刺腰麻在剖宫产手术中应用具有其独有微创的优点,特别是在对局部穿刺点的损伤好于腰硬联合穿刺腰麻,但在可控性方面(不能椎管内追加局麻药物)不如腰硬联合穿刺腰麻。 Objective: To explore the advantages and disadvantages of using fine needle aspiration alone in cesarean section. Methods: One hundred and twenty-two cases of cesarean section were randomly divided into group A (group B) and group 610 (group B). The two groups were compared in a successful puncture, puncture pain, wear dura mater, complications of catheterization (vascular invasion, catheter invasion, abnormal sensation), etc. On the first day after operation (T1), on the second day ), The 3rd to 5th days (T3), the 7th day (T7) were followed up to observe the puncture site red and tenderness. Results: There was no significant difference in the success rate of puncture between group A and group B (P> 0.05), puncture pain was statistically significant (P <0.05), penetrating the dura mater, group B without catheter insertion, There was no significant difference between T3 and T7 after operation (P> 0.05). There was no significant difference between T1 and T2 after operation (P> 0.05). Conclusion: The use of fine needle alone puncture spinal anesthesia in cesarean section has the advantage of its unique minimally invasive, especially in the local puncture point of injury is better than waist and hard joint puncture spinal anesthesia, but in terms of controllability (not Spinal additional local anesthetic drugs) as spinal joint hard waist spinal anesthesia.
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