探討不同麻醉方式對剖腹產術後表現之產婦及新生兒影響—以中部某醫學中心為例

The Effect of Different Anesthesia Methods on Maternal and Neonatal Performance after Caesarean Section - Evidence of a Medical Center in Central Taiwan

陳姿言(TZU-YEN CHEN)

指導教授 ： 許哲瀚

中臺科技大學/管理學院/醫療暨健康產業管理系碩士班/碩士(2017年)

摘要

目的：隨時代變遷致生育年齡延後及醫學知識及技術的進步，發生高危險妊娠的產婦有增無減，使得產婦的麻醉變得更為複雜、更難處理。本研究旨在探討不同麻醉方式對剖腹產術後表現之產婦及新生兒現況與相關性。
方法：本研究採回溯病歷資料，獲得人體試驗委員會同意後，以中部某醫學中心在2014年1月到2016年12月所有剖腹產的產婦及新生兒病歷資料進行分析。將產婦分為高危險妊娠與一般妊娠，採用Window for SPSS 22.0統計軟體進行描述性分析與推理性分析，並進行皮爾森相關與多元逐步迴歸方式。
結果：對產婦而言，脊髓麻醉比全身麻醉在懷孕週數(p=.000)、出血量(p=.000)及輸液量(p=.000)達顯著差異；脊髓麻醉比脊髓麻醉改全身麻醉在出血量(p=.000)、輸液量(p=.020)達顯著差異。
對新生兒而言，新生兒出生的第一分鐘Apgar score分數與出生第五分鐘Apgar score分數在脊髓麻醉比脊髓麻醉全身麻醉(p=.000)與(p=.000)、全身麻醉比脊髓麻醉改全身麻醉(p=.022)與(p=.000)皆達顯著差異。
結論：產婦為了孕育胎兒，產生諸多生理的變化，這些變化使得孕婦的生理跟一般人不一樣，然而全身麻醉對於剖腹產的產婦及胎兒都有顯著的影響，因此產婦採脊髓麻醉的方式進行剖腹產，可達到產婦及胎兒相對的安全性。

關鍵字

麻醉方式 ； 剖腹產 ； 術後表現 ； 產婦 ； 新生兒

並列摘要

Objective: With the prolongation of childbearing age and the advancement of medical knowledge and technology, the incidence of high risk pregnant mothers has increased, making maternal anesthesia more complicated and difficult to deal with. The aim of this study was to investigate the status and relevance of different anesthesia patterns in maternal and newborns after caesarean section.
Methods: This study was used to analyze the maternal and neonatal medical records of all caesarean sections from January 2014 to December 2016, with the consent of the Human Test Committee. The maternal was divided into high risk pregnancy and general pregnancy. The descriptive analysis and reasoning analysis of Window for SPSS22.0 statistical software were carried out, and Pearson correlation and linear regression were used.
Results: In the case of maternal, spinal anesthesia was significantly different from that of general anesthesia (p = .000), bleeding (p = .000) and infusion (p = .000); spinal anesthesia General anesthesia in the amount of bleeding (p = .000), infusion volume (p = .020) significant difference. For neonates, neonatal births of the first minute Apgar score score with birth fifth minute Apgar score score in spinal anesthesia than spinal anesthesia with general anesthesia (p = .000) with (p = .000), general anesthesia than spinal anesthesia modified general anesthesia (p = .022) and (p = .000) were significant differences.
Conclusion: maternal in order to nurture the fetus, resulting in many physiological changes, these changes make pregnant women's physiology with the general person is not the same, but general anesthesia for caesarean section of maternal and fetal have a significant impact, so maternal spinal cord anesthesia way of caesarean section To achieve the relative safety of maternal and fetal.

並列關鍵字

anesthesia ； caesarean section ； postoperative performance ； maternal ； neonatal

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