【摘要】 目的比较钢丝加强聚脲胺酯硬膜外导管与聚氯乙烯硬膜外导管对硬膜外置管不良事件发生的影响。方法 200例拟行连续硬脊膜外腔阻滞麻醉(CEA)或蛛网膜下腔阻滞联合硬脊膜外腔阻滞麻醉(CSEA)患者,随机分为普通聚氯乙烯硬膜外导管组(A组)和钢丝加强聚脲胺酯硬膜外导管组(B组),每组100例,以阻力消失和负压现象作为判断穿刺针达到硬膜外腔的标志,两组置入相应的硬膜外导管,记录硬膜外置管受阻、置管时异感、回抽见血、回抽见脑脊液、推药遇阻、术后感觉异常及硬膜外血肿的发生情况。结果 B组置管受阻、推药遇阻、置管时异感、术后异感、回抽见血、回抽见脑脊液的发生率(2%、0、1%、0、1%、0)低于A组(18%、9%、15%、4%、13%、4%),差异均具有统计学意义(P<0.05)。两组术后均无硬膜外血肿压迫症状。结论采用钢丝加强聚脲胺酯硬膜外导管可降低椎管内麻醉置管不良事件的发生率,值得推广。更多还原

【Abstract】 Objective To compare influence of polyurea amine esterepidural catheters strengthened by steel wire and polyvinyl chloride epidural catheters on adverse events of epidural catheterization. Methods A total of 200 patients treated with continuous epidural block anesthesia(CEA) or subarachnoid anesthesia combined epidural block anesthesia(CSEA) were randomly divided into ordinary polyvinyl chloride epidural catheters group(group A) and polyurea amine esterepidural catheters strengthened by steel wire group(group B), with 100 cases in each group. Resistance disappearing and negative pressure appearance were taken as sign of puncture needle achieving epidural space. Esterepidural catheters were implanted in both groups respectively and recorded the incidence of epidural catheterization resistance, catheterization paresthesia, pumpback with blood, pumpback with cerebrospinal fluid, injection resistance, postoperative paresthesia and epidural hematoma. Results Group B had lower incidence of epidural catheterization resistance, catheterization paresthesia, pumpback with blood, pumpback with cerebrospinal fluid(2%, 0, 1%, 0, 1% and 0) than group A(18%, 9%, 15%, 4%, 13% and 4%), and the difference had statistical significance(P<0.05). Both groups had no epidural hematoma compression symptoms. Conclusion Application of polyurea amine esterepidural catheters strengthened by steel wire can decreasing incidence of adverse catheterization events. This method is worth promotion.更多还原