子癇前期患者麻醉管理新進展_West China Medical Journal

Authors：

 顧娟 ¹ , 周容 ² ,  羅東 ¹

1. ;
2. ;

Corresponding?author：

羅東, Email: luodong8706@163.com

Keywords：

子癇前期; 麻醉; 血壓; 鎮痛; 超聲

DOI：

10.7507/1002-0179.20150275

Video：

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子癇前期是一種妊娠期特發性疾病，是導致孕產婦和圍產兒患病率及和死亡率升高的主要原因之一。恰當的麻醉監護與處理，可以預防一些并發癥的發生，改善子癇前期患者的預后。現就子癇前期患者在圍麻醉期的血壓控制、液體管理、分娩鎮痛、剖宮產麻醉、術后鎮痛以及超聲應用新進展作一綜述，為麻醉管理提供新的臨床依據。

Citation： 顧娟, 周容, 羅東. 子癇前期患者麻醉管理新進展. West China Medical Journal, 2015, 30(5): 963-966. doi: 10.7507/1002-0179.20150275 Copy

1.	Samadi AR, Mayberry RM, Zaidi AA, et al. Maternal hypertension and associated pregnancy complications among African-American and other women in the United States[J]. Obstet Gynecol, 1996, 87(4):557-563.
2.	豐有吉, 沈鏗. 婦產科學[M]. 2版. 北京:人民衛生出版社, 2010:78.
3.	ACOG Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia[J]. Obstet Gynecol, 2002, 99(1):159-167.
4.	Steegers EA, Von Dadelszen P, Duvekot JJ, et al. Pre-eclampsia[J]. Lancet, 2010, 376(9741):631-644.
5.	Duley L. The global impact of pre-eclampsia and eclampsia[J]. Semin Perinatol, 2009, 33(3):130-137.
6.	Cantwell R, Clutton-Brock T, Cooper G, et al. Saving mothers' lives:reviewing maternal deaths to make motherhood safer:2006-2008. the eighth report of the confidential enquiries into maternal deaths in the United Kingdom[J]. BJOG, 2011, 118(Suppl 1):1-203.
7.	Mander R, Smith GD. Saving mothers' lives (formerly why mothers die):reviewing maternal deaths to make motherhood safer 2003-2005[J]. Midwifery, 2008, 24(1):8-12.
8.	Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy[J]. Hypertension, 2008, 51(4):960-969.
9.	Duley L, Henderson-Smart DJ, Meher S. Drugs for treatment of very high blood pressure during pregnancy[J]. Cochrane Database Syst Rev, 2013, 7:CD001449.
10.	National Collaborating Centre for Women's and Children's Health (UK). Hypertension in pregnancy:the management of hypertensive disorders during pregnancy. (RCOG Press, London (2010 Aug). NICE Clinical Guidelines, No. 107[M/OL]. London:ASOGPress, 2010. www.ncbi.nlm.nih.gov/books/NBK62652.
11.	劉倩倩, 余艷紅, 龔時鵬, 等. 硝苯地平治療重度子癇前期患者臨床療效與圍產兒結局的薈萃分析[J]. 中華婦產科雜志, 2012, 47(8):592-597.
12.	European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy:the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2011, 32(24):3147-3197.
13.	Sriram S, Robertson MS. Critically ill obstetric patients in Australia:a retrospective audit of 8 years' experience in a tertiary intensive care unit[J]. Crit Care Resusc, 2008, 10(2):124.
14.	Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises[J]. Best Pract Res Clin Obstet Gynaecol, 2013, 27(6):877-884.
15.	Sidani M, Siddik-Sayyid SM. Preeclampsia, a new perspective in 2011[J]. Middle East J Anaesthesiol, 2011, 21(2):207-214.
16.	Thornton CE, Von Dadelszen P, Makris A, et al. Acute pulmonary oedema as a complication of hypertension during pregnancy[J]. Hypertension Pregnancy, 2011, 30(2):169-179.
17.	Magee LA, Lowe S, Douglas MJ, et al. Therapeutics and anaesthesia[J]. Best Pract Res Clin Obstet Gynaecol, 2011, 25(4):477-490.
18.	Abramovici A, Szychowski JM, Biggio JR, et al. Epidural use and clinical chorioamnionitis among women who delivered vaginally[J]. Am J Perinatol, 2014, 31(11):1009-1014.
19.	Shnider SM, Abboud TK, Artal R, et al. Maternal catecholamines decrease during labor after lumbar epidural anesthesia[J]. Am J Obstet Gynecol, 1983, 147(1):13-15.
20.	Visalyaputra S, Rodanant O, Somboonviboon W, et al. Spinal versus epidural anesthesia for cesarean delivery in severe preeclampsia:a prospective randomized, multicenter study[J]. Anesth Analg, 2005, 101(3):862-868, table of contents.
21.	Huang CJ, Fan YC, Tsai PS. Differential impacts of modes of anaesthesia on the risk of stroke among preeclamptic women who undergo caesarean delivery:a population-based study[J]. Br J Anaesth, 2010, 105(6):818-826.
22.	Yoo KY, Kang DH, Jeong H, et al. A dose-response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women undergoing caesarean delivery under general anaesthesia[J]. Int J Obstet Anesth, 2013, 22(1):10-18.
23.	Mcdonnell JG, Curley G, Carney J, et al. The analgesic efficacy of transversus abdominis plane block after cesarean delivery:a randomized controlled trial[J]. Anesth Analg, 2008, 106(1):186-191, table of contents.
24.	Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after cesarean delivery:a systematic review and meta-analysis[J]. Can J Anaesth, 2012, 59(8):766-778.
25.	Melchiorre K, Sutherland GR, Baltabaeva A, et al. Maternal cardiac dysfunction and remodeling in women with preeclampsia at term[J]. Hypertension, 2011, 57(1):85-93.
26.	Société fran?aise d'anesthésie et de réanimation (Sfar),Collège national des gynécologues et obstétriciens fran?ais (CNGOF), Société fran?aise de médecine périnatale (SFMP), et al. Multidisciplinary management of severe pre-eclampsia. Experts' guidelines 2008[J]. Ann Fr Anesth Reanim, 2009, 28(3):275-281.
27.	Wei J, Yang HS, Tsai SK, et al. Emergent bedside real-time three-dimensional transesophageal echocardiography in a patient with cardiac arrest following a caesarean section[J]. Eur J Echocardiogr, 2011, 12(3):E16.
28.	Volpicelli G, Cardinale L, Mussa A, et al. Diagnosis of cardiogenic pulmonary edema by sonography limited to the anterior lung[J]. Chest, 2009, 135(3):883; author reply 883-884.
29.	Norwitz ER, Hsu CD, Repke JT. Acute complications of preeclampsia[J]. Clin Obstet Gynecol, 2002, 45(2):308-329.
30.	Lichtenstein D. Should lung ultrasonography be more widely used in the assessment of acute respiratory disease?[J]. Expert Rev Respir Med, 2010, 4(5):533-538.
31.	Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound[J]. Intensive Care Med, 2012, 38(4):577-591.
32.	Agricola E, Picano E, Oppizzi M, et al. Assessment of stress-induced pulmonary interstitial edema by chest ultrasound during exercise echocardiography and its correlation with left ventricular function[J]. J Am Soc Echocardiogr, 2006, 19(4):457-463.
33.	Bouhemad B, Zhang M, Lu Q, et al. Clinical review:bedside lung ultrasound in critical care practice[J]. Crit Care, 2007, 11(1):205.
34.	Lichtenstein DA, Mezière GA, Lagoueyte JF, et al. A-lines and B-lines:lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill[J]. Chest, 2009, 136(4):1014-1020.
35.	Zieleskiewicz L, Contargyris C, Brun C, et al. Lung ultrasound predicts interstitial syndrome and hemodynamic profile in parturients with severe preeclampsia[J]. Anesthesiology, 2014, 120(4):906-914.
36.	Balki M, Lee Y, Halpern S, et al. Ultrasound imaging of the lumbar spine in the transverse plane:the correlation between estimated and actual depth to the epidural space in obese parturients[J]. Anesth Analg, 2009, 108(6):1876-1881.
37.	Grau T, Leipold RW, Conradi R, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia[J]. J Clin Anesth, 2002, 14(3):169-175.
38.	Grau T, Leipold RW, Fatehi S, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia[J]. Eur J Anaesthesiol, 2004, 21(1):25-31.

1. Samadi AR, Mayberry RM, Zaidi AA, et al. Maternal hypertension and associated pregnancy complications among African-American and other women in the United States[J]. Obstet Gynecol, 1996, 87(4):557-563.
2. 豐有吉, 沈鏗. 婦產科學[M]. 2版. 北京:人民衛生出版社, 2010:78.
3. ACOG Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia[J]. Obstet Gynecol, 2002, 99(1):159-167.
4. Steegers EA, Von Dadelszen P, Duvekot JJ, et al. Pre-eclampsia[J]. Lancet, 2010, 376(9741):631-644.
5. Duley L. The global impact of pre-eclampsia and eclampsia[J]. Semin Perinatol, 2009, 33(3):130-137.
6. Cantwell R, Clutton-Brock T, Cooper G, et al. Saving mothers' lives:reviewing maternal deaths to make motherhood safer:2006-2008. the eighth report of the confidential enquiries into maternal deaths in the United Kingdom[J]. BJOG, 2011, 118(Suppl 1):1-203.
7. Mander R, Smith GD. Saving mothers' lives (formerly why mothers die):reviewing maternal deaths to make motherhood safer 2003-2005[J]. Midwifery, 2008, 24(1):8-12.
8. Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy[J]. Hypertension, 2008, 51(4):960-969.
9. Duley L, Henderson-Smart DJ, Meher S. Drugs for treatment of very high blood pressure during pregnancy[J]. Cochrane Database Syst Rev, 2013, 7:CD001449.
10. National Collaborating Centre for Women's and Children's Health (UK). Hypertension in pregnancy:the management of hypertensive disorders during pregnancy. (RCOG Press, London (2010 Aug). NICE Clinical Guidelines, No. 107[M/OL]. London:ASOGPress, 2010. www.ncbi.nlm.nih.gov/books/NBK62652.
11. 劉倩倩, 余艷紅, 龔時鵬, 等. 硝苯地平治療重度子癇前期患者臨床療效與圍產兒結局的薈萃分析[J]. 中華婦產科雜志, 2012, 47(8):592-597.
12. European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy:the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2011, 32(24):3147-3197.
13. Sriram S, Robertson MS. Critically ill obstetric patients in Australia:a retrospective audit of 8 years' experience in a tertiary intensive care unit[J]. Crit Care Resusc, 2008, 10(2):124.
14. Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises[J]. Best Pract Res Clin Obstet Gynaecol, 2013, 27(6):877-884.
15. Sidani M, Siddik-Sayyid SM. Preeclampsia, a new perspective in 2011[J]. Middle East J Anaesthesiol, 2011, 21(2):207-214.
16. Thornton CE, Von Dadelszen P, Makris A, et al. Acute pulmonary oedema as a complication of hypertension during pregnancy[J]. Hypertension Pregnancy, 2011, 30(2):169-179.
17. Magee LA, Lowe S, Douglas MJ, et al. Therapeutics and anaesthesia[J]. Best Pract Res Clin Obstet Gynaecol, 2011, 25(4):477-490.
18. Abramovici A, Szychowski JM, Biggio JR, et al. Epidural use and clinical chorioamnionitis among women who delivered vaginally[J]. Am J Perinatol, 2014, 31(11):1009-1014.
19. Shnider SM, Abboud TK, Artal R, et al. Maternal catecholamines decrease during labor after lumbar epidural anesthesia[J]. Am J Obstet Gynecol, 1983, 147(1):13-15.
20. Visalyaputra S, Rodanant O, Somboonviboon W, et al. Spinal versus epidural anesthesia for cesarean delivery in severe preeclampsia:a prospective randomized, multicenter study[J]. Anesth Analg, 2005, 101(3):862-868, table of contents.
21. Huang CJ, Fan YC, Tsai PS. Differential impacts of modes of anaesthesia on the risk of stroke among preeclamptic women who undergo caesarean delivery:a population-based study[J]. Br J Anaesth, 2010, 105(6):818-826.
22. Yoo KY, Kang DH, Jeong H, et al. A dose-response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women undergoing caesarean delivery under general anaesthesia[J]. Int J Obstet Anesth, 2013, 22(1):10-18.
23. Mcdonnell JG, Curley G, Carney J, et al. The analgesic efficacy of transversus abdominis plane block after cesarean delivery:a randomized controlled trial[J]. Anesth Analg, 2008, 106(1):186-191, table of contents.
24. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after cesarean delivery:a systematic review and meta-analysis[J]. Can J Anaesth, 2012, 59(8):766-778.
25. Melchiorre K, Sutherland GR, Baltabaeva A, et al. Maternal cardiac dysfunction and remodeling in women with preeclampsia at term[J]. Hypertension, 2011, 57(1):85-93.
26. Société fran?aise d'anesthésie et de réanimation (Sfar),Collège national des gynécologues et obstétriciens fran?ais (CNGOF), Société fran?aise de médecine périnatale (SFMP), et al. Multidisciplinary management of severe pre-eclampsia. Experts' guidelines 2008[J]. Ann Fr Anesth Reanim, 2009, 28(3):275-281.
27. Wei J, Yang HS, Tsai SK, et al. Emergent bedside real-time three-dimensional transesophageal echocardiography in a patient with cardiac arrest following a caesarean section[J]. Eur J Echocardiogr, 2011, 12(3):E16.
28. Volpicelli G, Cardinale L, Mussa A, et al. Diagnosis of cardiogenic pulmonary edema by sonography limited to the anterior lung[J]. Chest, 2009, 135(3):883; author reply 883-884.
29. Norwitz ER, Hsu CD, Repke JT. Acute complications of preeclampsia[J]. Clin Obstet Gynecol, 2002, 45(2):308-329.
30. Lichtenstein D. Should lung ultrasonography be more widely used in the assessment of acute respiratory disease?[J]. Expert Rev Respir Med, 2010, 4(5):533-538.
31. Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound[J]. Intensive Care Med, 2012, 38(4):577-591.
32. Agricola E, Picano E, Oppizzi M, et al. Assessment of stress-induced pulmonary interstitial edema by chest ultrasound during exercise echocardiography and its correlation with left ventricular function[J]. J Am Soc Echocardiogr, 2006, 19(4):457-463.
33. Bouhemad B, Zhang M, Lu Q, et al. Clinical review:bedside lung ultrasound in critical care practice[J]. Crit Care, 2007, 11(1):205.
34. Lichtenstein DA, Mezière GA, Lagoueyte JF, et al. A-lines and B-lines:lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill[J]. Chest, 2009, 136(4):1014-1020.
35. Zieleskiewicz L, Contargyris C, Brun C, et al. Lung ultrasound predicts interstitial syndrome and hemodynamic profile in parturients with severe preeclampsia[J]. Anesthesiology, 2014, 120(4):906-914.
36. Balki M, Lee Y, Halpern S, et al. Ultrasound imaging of the lumbar spine in the transverse plane:the correlation between estimated and actual depth to the epidural space in obese parturients[J]. Anesth Analg, 2009, 108(6):1876-1881.
37. Grau T, Leipold RW, Conradi R, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia[J]. J Clin Anesth, 2002, 14(3):169-175.
38. Grau T, Leipold RW, Fatehi S, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia[J]. Eur J Anaesthesiol, 2004, 21(1):25-31.

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子癇前期患者麻醉管理新進展

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