Effects of different anesthesia approaches on hemorheology in patients with pregnancy-induced hypertension during cesarean section / 中国医师进修杂志

ABSTRACT

ObjectiveTo explore the effects of different anesthesia approaches on hemorheology in patients with pregnancy-induced hypertension (PIH) during cesarean section.MethodsOne hundred and sixty-five patients with PIH were divided into epidural anesthesia (81 cases,control group) and combined spinal epidural anesthesia (84 cases,experiment group).The hemorheology and Apgar score were compared.Results The anesthesia and post-parturition,the levels of whole blood low shear viscosity,whole blood middle shear viscosity,whole blood high shear viscosity,erythrocyte aggregation index,plasma viscosity,fibrinogen were improved compared with those before anesthesia [experiment group(6.3 ± 0.7 ),(6.6 ± 0.6)mPa·s vs.(8.1 ± 1.8) mPa·s,(3.8±0.6),(3.9±0.4) mPa·s vs.(5.2±0.9) mPa·s,(3.1 ±0.8),(3.2±0.7) mPa·s vs. (4.5 ± 1.2) mPa·s,3.0 ±0.4,3.1 ±0.7 vs.2.8 ±0.7,(1.2 ±0.2),(1.1 ±0.5) mPa·s vs.(1.8 ±0.6) mPa·s,(5.3 ± 0.8),(5.3 ±0.7) g/L vs.(4.7 ±0.8) g/L;control group(7.9 ±0.8),(7.5 ±0.7)mPa·s vs.(8.2± 1.3) mPa·s,(4.5±0.4)、(4.5 ±0.4) mPa·s vs.(5.4±0.7) mPa·s,(3.7±0.8),(3.5±0.8 ) mPa· s vs. (4.6 ± 0.5 ) mPa· s,2.8 ± 0.6,2.9 ± 0.3 vs.2.7 ± 0.6,( 1.6 ± 0.4),( 1.7 ± 0.1 ) mPa· s vs.(1.9 ±0.8) mPa ·s,(5.0 ±0.9),(4.8 ±0.8) g/L vs. (4.7 ±0.5) g/L,P ＜0.05],and all the level of hemorheology in experiment group were improved compared with control group (P ＜ 0.05).There was no significant difference in 1,5 min Apgar scores between two groups (P ＞ 0.05).ConclusionThe epidural anesthesia and combined spinal epidural anesthesia can improve hemorheology of patients with PIH during cesarean section,but the combined spinal epidural anesthesia is more effective and favorable for pregnancy outcome.