妊娠晚期合并出血性脑血管病患者行剖宫产术的临床麻醉管理

doi:10.16352/j.issn.1001-6325.2026.06.0850

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (6): 850-854.doi: 10.16352/j.issn.1001-6325.2026.06.0850

妊娠晚期合并出血性脑血管病患者行剖宫产术的临床麻醉管理

张潇潇¹, 刘海洋¹, 张奇², 冯力民², 韩如泉^1*

1.首都医科大学附属北京天坛医院麻醉科,北京 100070;
2.首都医科大学附属北京天坛医院妇产科,北京 100070

收稿日期:2025-05-21 修回日期:2025-09-24 出版日期:2026-06-05 发布日期:2026-05-27
通讯作者: ^*ruquan.han@gmail.com

Clinical anesthetic management for cesarean section in patients with late pregnancy complicated by hemorrhagic cerebrovascular disease

ZHANG Xiaoxiao¹, LIU Haiyang¹, ZHANG Qi², FENG Limin², HAN Ruquan^1*

1. Department of Anesthesiology;
2. Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2025-05-21 Revised:2025-09-24 Online:2026-06-05 Published:2026-05-27
Contact: ^*ruquan.han@gmail.com

摘要/Abstract

摘要： 目的分析妊娠晚期合并出血性脑血管病患者的临床特点,总结其行剖宫产术的麻醉管理经验。方法回顾分析2020年1月1日至2025年1月1日于首都医科大学附属北京天坛医院妊娠晚期合并出血性脑血管病进行子宫下段剖宫产术患者的医疗记录。分析患者临床资料、多学科诊疗、麻醉管理及治疗转归。结果12例患者中急诊手术终止妊娠4例(33.3%),期待妊娠择期剖宫产8例(66.7%)。患者行剖宫产手术采用椎管内麻醉10例(83.3%),全身麻醉2例(16.7%)。除1例产妇未及时行神经外科手术再发脑出血外,其余产妇及胎儿结局较好。结论妊娠晚期合并出血性脑血管病变患者需多学科合作,麻醉管理并不能仅仅止于剖宫产术中,更应该重视整个围产期乃至产褥期的监护。

关键词: 妊娠, 麻醉, 脑血管畸形, 脑出血

Abstract: Objective To analyze the clinical characteristics of patients with hemorrhagic cerebrovascular disease in late pregnancy and summarize the anesthetic management experience for cesarean delivery. Methods Medical records of patients who underwent lower uterine segment cesarean section for hemorrhagic cerebrovascular disease in late pregnancy at Beijing Tiantan Hospital, Capital Medical University, from January 1, 2020, to January 1, 2025, were retrospectively reviewed. Clinical data, multidisciplinary treatment, anesthetic management, and the outcomes were analyzed. Results Among the 12 patients, 4 (33.3%) underwent emergency cesarean delivery for pregnancy termination, while 8 (66.7%) underwent elective cesarean delivery after expectant management. Neuraxial anesthesia was administered in 10 cases (83.3%), and general anesthesia in 2 cases (16.7%). Except for one case of recurrent cerebral hemorrhage due to delayed neurosurgical intervention, maternal and fetal outcomes were favorable. Conclusions Multidisciplinary collaboration is essential for management of late-pregnancy patients with hemorrhagic cerebrovascular disease. Anesthetic management should extend beyond the intraoperative period of cesarean delivery, emphasizing comprehensive monitoring throughout the perinatal and postpartum periods.

Key words: pregnancy, anesthesia, cerebrovascular malformation, cerebral hemorrhage

中图分类号:

R714.1
R614

张潇潇, 刘海洋, 张奇, 冯力民, 韩如泉. 妊娠晚期合并出血性脑血管病患者行剖宫产术的临床麻醉管理[J]. 基础医学与临床, 2026, 46(6): 850-854.

ZHANG Xiaoxiao. Clinical anesthetic management for cesarean section in patients with late pregnancy complicated by hemorrhagic cerebrovascular disease[J]. Basic & Clinical Medicine, 2026, 46(6): 850-854.

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妊娠晚期合并出血性脑血管病患者行剖宫产术的临床麻醉管理

Clinical anesthetic management for cesarean section in patients with late pregnancy complicated by hemorrhagic cerebrovascular disease

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