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-  2018 

传统和保守体表标志定位法用于剖宫产腰麻的对比研究 Comparison Between Traditional and Conservative Landmark Techniques for Spinal Anesthesia in Caesarean Section

Keywords: 超声,腰麻,剖宫产,髂嵴连线

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Abstract:

目的:为了减少脊髓损伤风险,利用超声技术评价传统和保守体表标志定位法,定位产妇腰穿间隙时出现L2-L3及以上间隙的发生率。方法:随机将152例足月产妇分为两组:传统和保守体表标志定位组。产妇右侧卧位下,根据两种不同体表标志法定位拟腰穿间隙,再利用超声技术评估拟穿刺间隙的实际棘突间隙,记录拟穿刺间隙出现L2-L3及以上间隙的例数。同时记录穿刺次数、穿刺异感、硬膜外和静脉给药次数和剂量、改全麻数量、术后头痛以及术后下肢感觉或者运动异常的例数。结果:传统定位组所选择的拟穿刺间隙中25例(34.2%)实际位于L2-L3及以上间隙;保守定位组中13例(17.8%)实际位于L2-L3及以上间隙,差异具有统计学意义(P=0.024)。两组反映穿刺难度、腰麻麻醉效果和麻醉相关并发症的指标之间的差异无统计学意义(P>0.05)。结论:触诊产妇髂嵴最高点连线与脊柱的相交点为棘突间隙时,选择此间隙为腰麻穿刺点;相交点为棘突时,选择下一位椎间隙为穿刺点——保守体表标志定位法,能够显著减少腰穿L2-L3及以上间隙的发生率

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