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浙江大学学报(医学版)  2020, Vol. 49 Issue (2): 249-252    DOI: 10.3785/j.issn.1008-9292.2020.03.04
原著     
一例妊娠合并2019冠状病毒病(COVID-19)患者的剖宫产麻醉管理
康仙慧(),张荣,何慧梁,姚永兴,郑跃英,温小红*(),祝胜美*()
浙江大学医学院附属第一医院麻醉科, 浙江 杭州 310003
Anesthesia management in cesarean section for patient with COVID-19: a case report
KANG Xianhui(),ZHANG Rong,HE Huiliang,YAO Yongxing,ZHENG Yueying,WEN Xiaohong*(),ZHU Shengmei*()
Department of Anesthesiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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摘要:

2019冠状病毒病(COVID-19)会影响妊娠妇女的心肺功能,其剖宫产术的麻醉管理和医护人员防护与普通手术显著不同。2020年2月8日浙江大学医学院附属第一医院成功实施一例妊娠合并COVID-19患者剖宫产手术,本文介绍围术期麻醉管理、医护人员防护和产妇心理干预等经验。应重视妊娠合并COVID-19患者术前评估和麻醉计划实施,COVID-19普通型患者剖宫产首选椎管内麻醉,注意减少对母婴呼吸循环的影响;重型和危重型患者应选择气管插管全身麻醉。加强医疗环境安全,麻醉医生应尽量采取三级标准防护。对于产妇心理应予特殊关注:术前加强解释说明减轻产妇焦虑;术中减轻产妇不适,缓解紧张情绪;术后避免产妇因疼痛而产生不良的情绪。

关键词: 2019冠状病毒病严重急性呼吸综合征冠状病毒2新型冠状病毒肺炎剖宫产术麻醉, 硬膜外病例报告    
Abstract:

Since the coronavirus disease 2019 (COVID-19) affects the cardio-pulmonary function of pregnant women, the anesthetic management and protection of medical staff in the cesarean section is significantly different from that in ordinary surgical operation. This paper reports a case of cesarean section for a woman with COVID-19, which was successfully performed in the First Affiliated Hospital of Zhejiang University School of Medicine on February 8, 2020. Anesthetic management, protection of medical staff and psychological intervention for the pregnant woman during the operation were discussed. Importance has been attached to the preoperative evaluation of pregnant women with COVID-19 and the implementation of anesthesia plan. For moderate patients, intraspinal anesthesia is preferred in cesarean section, and try to reduce its influence in respiration and circulation in both maternal and infant; general anesthesia with endotracheal intubation should be adopted for severe or critically ill patients. Ensure the safety of medical environment, and anesthetists should carry out level-Ⅲ standard protection. Special attention and support should be paid to maternal psychology: fully explanation before operation to reduce anxiety; relieve the discomfort during operation, so as to reduce tension; avoid the bad mood due to pain after operation.

Key words: Coronavirus disease 2019    Severe acute respiratory syndrome coronavirus 2    Novel coronavirus pneumonia    Cesarean section    Anesthesia, epidural    Case reports
收稿日期: 2020-02-29 出版日期: 2020-03-11
:  R614  
基金资助: 浙江大学“十三五”第一批教学改革研究项目(zdjg08077, zdjg08081)
通讯作者: 温小红,祝胜美     E-mail: kxhui66@zju.edu.cn;0087420@zju.edu.cn;smzhu20088@zju.edu.cn
作者简介: 康仙慧(1979-), 女, 博士, 副主任医师, 主要从事麻醉和疼痛的临床及基础研究; E-mail:kxhui66@zju.edu.cn; https://orcid.org/0000-0002-3132-3369
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引用本文:

康仙慧,张荣,何慧梁,姚永兴,郑跃英,温小红,祝胜美. 一例妊娠合并2019冠状病毒病(COVID-19)患者的剖宫产麻醉管理[J]. 浙江大学学报(医学版), 2020, 49(2): 249-252.

KANG Xianhui,ZHANG Rong,HE Huiliang,YAO Yongxing,ZHENG Yueying,WEN Xiaohong,ZHU Shengmei. Anesthesia management in cesarean section for patient with COVID-19: a case report. J Zhejiang Univ (Med Sci), 2020, 49(2): 249-252.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.03.04        http://www.zjujournals.com/med/CN/Y2020/V49/I2/249

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