麻醉疼痛科

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脊髓空洞症患者全麻下剖宫产一例

2018-01-14 佚名 临床麻醉学杂志

脊髓空洞症剖宫产
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产妇，25岁，150cm，60kg，G1P0，妊娠39周，

【一般资料】

产妇，25岁，150cm，60kg，G1P0，妊娠39周，

【现病史】

入院拟择期行剖宫产术。产妇自诉患先天性脊髓空洞症，从未治疗，病情稳定。

【体格检查】

脊柱侧弯，以正中矢状线为界表现为右侧肢体痛温觉减退，肌力减退，运动功能基本正常。

【辅助检查】

人室常规监测：BP125/70mmHg，HR92次/分，RR16次/分，SpO299%。

【治疗】

给予面罩吸氧，氧流量3L/min，静脉滴注复方氯化钠溶液。麻醉诱导静脉推注丙泊酚1.5mg/kg、瑞芬太尼0.5μg/kg（1min静脉缓推），未使用肌松药。待患者结膜反射消失后插入4号喉罩，接麻醉机维持机械通气，VT480ml，RR12次/分，氧流量2L/min，FiO2100%，维持PCTCO225~30mmHg。剖出一男婴后，米用瑞芬太尼0.2μg?kg-1?min-1、丙泊酚4mg?kg-1?h-1，静脉栗注维持麻醉。在第1、5、10分钟时对新生儿进行Apgar评分分别为9分、9分、10分。手术时间约30min，缝皮时停用麻醉药物，术毕自然清醒，痛温觉及肌力同术前，呼吸循环平稳，拔出喉罩，带镇痛栗安全转人病房。

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#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1476563, encodeId=3ca414e656395, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Jan 16 08:43:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278539, encodeId=6ef92e8539c6, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:44 CST 2018, time=2018-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278502, encodeId=77272e8502c4, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Sun Jan 14 20:05:07 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-16 柳叶一刀

    #全麻#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1476563, encodeId=3ca414e656395, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Jan 16 08:43:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278539, encodeId=6ef92e8539c6, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:44 CST 2018, time=2018-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278502, encodeId=77272e8502c4, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Sun Jan 14 20:05:07 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-14 changjiu

    学习一下谢谢

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1476563, encodeId=3ca414e656395, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Jan 16 08:43:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278539, encodeId=6ef92e8539c6, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jan 14 23:22:44 CST 2018, time=2018-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278502, encodeId=77272e8502c4, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Sun Jan 14 20:05:07 CST 2018, time=2018-01-14, status=1, ipAttribution=)]
    2018-01-14 hhh678

    henhao

    0