在接受剖腹产的患者中,高脊柱阻塞的风险预测得分:一个追溯的队列研究
Pannawit Benjhawaleemas1, Baramee Brahmasakha Na Sakolnagara1, Jutarat Tanasansuttiporn1
1Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla, 90110, Thailand.
BMC anesthesiology
|November 11, 2024
概括
一个新的风险评分有助于预测剖腹产期间的高脊柱阻塞. 关键因素包括妊娠年龄,BMI,布皮瓦卡因剂量和提供者经验,有助于预防策略.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 手术风险评估手术风险评估
背景情况:
- 高脊柱阻塞是脊柱麻醉的重要并发症.
- 关于高脊柱阻塞风险因素的现有研究不一致.
- 不存在高脊柱阻塞的验证风险预测得分.
研究的目的:
- 开发和验证高脊柱阻塞的风险预测得分.
- 在脊髓麻醉下进行剖腹产的患者中确定高脊柱阻塞的关键预测因素.
主要方法:
- 对1003名分娩者进行了回顾性队列研究,这些分娩者在剖腹产时接受脊髓麻醉.
- 收集的数据包括人口统计,妊娠年龄,布皮瓦卡因剂量,阻塞水平和血压.
- 高脊柱阻塞定义为感觉阻塞> T4;风险得分来自多变量逻辑回归.
主要成果:
- 高脊柱阻塞的发生率为22.4%.
- 预测因素包括:妊娠年龄<35周,身高<150厘米,BMI>27.5公斤/米2,布皮瓦卡因剂量>11毫克,第一年住院医生进行阻断,之前的剖腹产和选择性剖腹产.
- 风险预测工具将患者分为低风险,中等风险和高风险组.
结论:
- 患者和麻醉相关因素显著导致高脊柱阻塞风险.
- 诸如妊娠年龄,布皮瓦卡因剂量和提供者经验等可修改因素对于降低风险至关重要.
- 开发的风险评分可以帮助尽量减少剖腹产期间高脊柱阻塞发生率.
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