牵拉子宫时血流动力学变化与血浆PGI_2变化的关系

Relation ship between the Hemodynamic Change and Plasma Prostacyclin Level during Uterectomy

探讨硬膜外阻滞下行子宫切除术牵拉子宫时血流动力学变化和血浆前列环素变化的关系。２０例病人，ＡＳＡⅠ～Ⅱ级，采用自身对照的方法，于麻醉前、牵拉子宫前、牵拉后５ｍｉｎ、１０ｍｉｎ、１５ｍｉｎ及子宫切除后观察病人血流动力学变化。同时随机选其中１０例抽血测定血浆前列环素和血栓素的变化。结果：牵拉子宫后，ＭＡＰ、ＴＰＲ、ＰＡＷＰ均明显下降，而ＰＧＩ２明显升高，高峰出现于牵拉后１０ｍｉｎ。这提示ＰＧＩ２增加是导致子宫牵拉血流动力学变化的因素之一。

he relationship between the hemodynamic change and plasma prostacyclin level was studied in 20 patients undergoing uterectomy under epidural anesthesia. HR,MAP,CO,TPR and PAWP were taken pre-anesthsia,beforeuterus traction,at 5 min, 10min and 15min postuterus traction and uterectomy. Plasma samples were drawn at thetime points as above for analysis of prostacyclin(6-keto-PGF1α)and thrombozane A2 (TXB2)concentration by ra-dioimmunoasay, It was found that uterus traction resulted in a significant decrease in MAP,TPR,PAWP and a sig-nificant increase in 6-keto-PFG1α concentrations at 10min post-uterus traction. It is concluded that plasma prostacy-clin has a close relationship with the hemodynamic response during uterus traction.