复方氨基酸液母体静脉及羊膜腔内输注对胎儿影响的探讨

Biochemical Effects of Maternal Intravenous and Intra-amniotic Infusion of Amino-Acids on Fetal Blood

作者对５８例正常足月妊娠拟行择期剖宫产术的孕妇，于术前３～４小时经母体静脉（静脉组）及羊膜腔内（羊膜腔组）分别输入等量复方氨基酸液，与对照组（不输任何药物）对比，观察母血及胎儿脐血（脐动脉和静脉）中游离氨基酸水平。结果：静脉组中母血及胎儿脐血的游离氨基酸及总氨基酸水平高于对照组（Ｐ＜０．０５），但胎儿对多数氨基酸的吸收无明显增加（Ｐ＞０．０５）；羊膜腔组中胎儿脐血的游离氨基酸及总氨基酸水平高于静脉组和对照组（Ｐ＜０．０５），胎儿对氨基酸的吸收增加（Ｐ＜０．０５）。两种途径给药对胎儿脐动脉血ｐＨ、ＰＯ＿２、ＰＣＯ＿２均无影响（Ｐ＞０．２）。羊膜腔内输注氨基酸前后其内压力无明显改变（Ｐ＞０．２）．我们研究的结果初步表明羊膜腔内给药对于胎儿宫内生长发育迟缓（ＩＵＧＲ），尤其是有严重胎盘功能障碍者有望成为一种有效的治疗途径。

Before elective cesarean section,58normal term’s pregnant women were randomly dividedinto three groups:intravenous(25 women),intra-am-niotic( 8 women)and control(25 women)groups.The first two groups received maternal intravenousand intra-amniotic infusion of amino acids respective-ly. The results showed that maternal intravenous ad-ministration of amino-acids led to increased levels ofamino acids in maternal venous blood and fetal umbili-cal cord blood plasma(P<0.05).There was no in-crease in fetal uptake of amino acids(P> 0. 05).Thelevels of amino acids in fetal umbilical cord blood plas-ma Of the intra-amniotic group were higher than thoseof the control group(P<0. 05)and intravenous group(P<0.05).In the intra-amniotic group. the fetal up-take of amino acids increased (P<0.05).There wereno significant differences in fetal umbilical arteriouspH, PO_2 and PCO_2 among the three groups(P>0.2).Intra-amniotic infusion of 250ml amino-acids did notchange the pressure of amniotic cavity(P>0.2). Theauthors suggested that intra-amniotic infusion ofamino acids,as a paraplacental nutrional route,shopldbe more effective in the treatment for cases of in-trauterine fetal growth retardation particularly forthose accompanied by severe placental lesions.