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題名 | Lumbar Epidural Space was Narrower in Parturients Than that in Nonpregnant Women by Ultrasound Assessment=藉由超音波輔助確定產婦之硬脊膜外腔較非孕婦狹窄 |
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作者 | 盧奕丞; 黃書鴻; 許瓊丹; 邱矜曦; 吳昇樺; Lu, I-cheng; Huang, Shu-hung; Hsu, Chiung-dan; Chiu, Chin-hsi; Wu, Sheng-hua; |
期刊 | The Kaohsiung Journal of Medical Sciences |
出版日期 | 20110100 |
卷期 | 27:1 2011.01[民100.01] |
頁次 | 頁20-24 |
分類號 | 417.372 |
語文 | eng |
關鍵詞 | 腰椎硬脊膜外; 超音波; 產婦; Lumbar epidural; Parturient; Ultrasound; |
中文摘要 | 腰椎硬脊膜外阻斷術常用於產婦之減痛分娩及剖腹產之麻醉與術後止痛,一般認為產婦的硬脊膜外腔會比非懷孕女性較窄且較深,因此增加硬脊膜外阻斷術的困難度。本研究目的在於探討,在超音波掃描下懷孕與非懷孕婦女之腰椎解剖構造的差異,以期協助硬脊膜外阻斷術之操作。30名產婦及非懷孕的女性自願者接受超音波檢測,以低頻超音波探頭檢測受測者之腰椎第二到三節、第三到四節,及第四到五節之解剖構造。使用超音波從中線側掃描,測量每ㄧ節之間硬脊外腔的間距以及從表皮至硬脊外腔的深度,並觀察每ㄧ節間超音波影像的品質,以四等分法,再以兩組的結果來加以分析。懷孕者與非懷孕者的腰椎硬脊膜外腔的深度分別為3.53 ± 0.62 以及3.25 ± 0.63(p < 0.05) 公分。懷孕者與非懷孕者的腰椎硬脊膜外腔的間距分別為3.03 ± 0.45以及4.44 ± 0.49(p < 0.05) 公厘。懷孕者與非懷孕者的超音波影像的品質分數分別為2.58 ± 0.58以及2.63 ± 0.53 (p=0.08) 。在超音波檢測下證實孕婦的腰椎硬脊膜外腔較窄且較深,而兩組之間的超音波影像品質並沒有明顯的差異。本文以量化的方式來增進對產婦及非孕婦之間硬脊膜外腔解剖差異的了解,期能藉由超音波的輔助下,減少併發症的產生。 |
英文摘要 | Abstract Labor epidural is commonly used to provide both regional anesthesia and postoperative pain relief. Epidural space is supposed to be narrower and deeper in parturient than that in nonpregnant woman. The aim of this study was to explore the difference of epidural spaces between parturient and nonpregnant women by ultrasound assessment. Thirty nonpregnant female volunteers and 30 parturients undergoing labor epidurals were enrolled to receive ultrasound examination. low-frequency (2~5 MHz) curved-array ultrasound probe was used to obtain spinal sonoanatomy for each subject. The longitudinal paramedian scanning plane was used to obtain optimal ultrasound image for spinal sonoanatomy. Primary outcome was evaluated by the diameter and depth of epidural space at three lumbar interspaces (from L2 to L5). The quality of ultrasound images was also compared between the groups by numerical scoring system (from 0 to 3). The mean diameters of lumbar epidural spaces were 3.03 ± 0.45 mm and 4.44 ± 0.49 mm (p < 0.05) for parturients and nonpregnant women, respectively. The mean depths of lumbar epidural spaces for parturients and nonpregnant womenwere3.53 ± 0.62 cm and 3.25 ± 0.63 cm, respectively (p < 0.05). The mean scores for epidural space image quality were 2.58 ± 0.58 and 2.63 ± 0.53 for parturients and nonpregnant women, respectively (p=0.08). Epidural space is narrower and deeper at lumbar inter-spaces in obstetrics by ultrasound examination. The quality of ultrasound images did not differ significantly between the groups. These quantitative results improve the understanding of the differences between two groups that have been previously known qualitatively and may help in avoiding complications. |
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