[1]史景发,汪胜友*.剖宫产产妇腰麻后低血压危险因素前瞻性多元逐步Logistic回归分析[J].中国计划生育和妇产科,2018,(12):41-45.
　SHI Jing-fa,WANG Sheng-you*.Prospective multivariate logistic regression analysis of risk factors for hypotension after cesarean section in women with spinal anesthesia[J].Chinese Journal of Family Planning & Gynecotokology,2018,(12):41-45.
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剖宫产产妇腰麻后低血压危险因素前瞻性多元逐步Logistic回归分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年12期
页码:
41-45
栏目:
论著与临床
出版日期:
2018-12-25

文章信息/Info

Title:
Prospective multivariate logistic regression analysis of risk factors for hypotension after cesarean section in women with spinal anesthesia
作者:
史景发; 汪胜友*
安徽医科大学附属妇幼保健院 安徽省妇幼保健院麻醉科
Author(s):
SHI Jing-fa; WANG Sheng-you*
Department of Anesthesiology,Anhui Women and Child Health Care Hospital,Hefei Anhui 230001,P.R.China
关键词:
剖宫产; 腰麻; 低血压; 危险因素
Keywords:
cesarean section; spinal anesthesia; hypotension; risk factors
分类号:
R 7198
摘要:
目的分析剖宫产产妇腰麻后低血压的危险因素。方法用预制的调查表收集2017年6～12月安徽省妇幼保健院在腰麻下行择期剖宫产产妇212例的临床资料，包括产妇的一般资料、产科及麻醉相关指标，观察记录产妇腰麻后是否发生低血压及低血压的处理情况。采用多元逐步Logistic回归筛选产妇腰麻后低血压的常见危险因素。结果212例剖宫产产妇中发生低血压108例（509 %），其中经体位调节加单次升压药物处理可纠正的低血压67例（316 %），另需多次升压药物及其他措施处理的难纠正低血压41例（193 %）；Logistic回归分析结果显示：产妇体质量指数（body mass index,BMI）≥28 kg/m2、宫高＞36 cm、手术开始麻醉平面>T6、麻醉3 min后平面≥T8是产妇腰麻后低血压危险因素；此外BMI≥28 kg/m2、多胎妊娠、麻醉3 min后平面≥T8是产妇发生难纠正性低血压的危险因素（P<005）。结论 术前应重视识别BMI、产妇宫高指标及多胎妊娠等产妇腰麻后低血压的危险因素，防止麻醉平面过高及上升过快，合理预防和处理低血压，保障母婴安全。
Abstract:
ObjectiveTo analyze the risk factors of hypotension after cesarean section in women with spinal anesthesia. MethodsThe pre-made questionnaire was used to collect the clinical data of 212 women who underwent cesarean section under the spinal anesthesia from June to December 2017 at Anhui Women and Child Health Care Hospital, including general information on maternity, obstetrics and anesthesia related indicators. Observed the treatment of hypotension and hypotension after maternal spinal anesthesia.Multivariate stepwise logistic regression was used to screen for common risk factors for hypotension after spinal anesthesia. ResultsAmong the 212 cases of cesarean section, 108 cases (509 %) had hypotension. Among them, 67 cases (316 %) had hypotension corrected by position adjustment plus single-boosting drug treatment. The measures were difficult to correct hypotension in 41 cases (193 %); Logistic regression analysis showed that the body mass index (BMI)≥28 kg/m2, the palace height>36 cm, the anesthesia plane>T6 after surgery, and the plane ≥T8 after 3 minutes of anesthesia were hypotension risk factors after maternal spinal anesthesia; In addition, BMI≥28 kg/m2, multiple pregnancy, and plane≥T8 after 3 minutes of anesthesia were risk factors for refractory hypotension in women(P<005). ConclusionPreoperative attention should be paid to identify risk factors for hypotension after spinal anesthesia, such as BMI, maternal height index and multiple pregnancy, to prevent the anesthesia plane from being too high and rising too fast, and to prevent and treat hypotension reasonably to ensure maternal and child safety.

参考文献/References:

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备注/Memo

备注/Memo:
合肥市卫生计生应用医学研究项目（项目编号：hwk2017zd003）
更新日期/Last Update: 2018-12-25