心脏病产妇剖宫产中循环功能的监测

Circulatory Function Monitoring of Pregnant Women With Organic Heart Disease during Cesearean Section

为观察不同类型心脏病患者连硬麻醉剖宫产术中循环功能变化,提高母婴生命安全,采用超声多普勒连续测定术中血流动力学变化。62例心脏病患者,分为1.后天性心脏病(Ⅰ组,n=24);2.先心左→右分流(Ⅱ组,n=21);3.先心右一→分流(Ⅲ组,n=17)。按心功能分为1.心功能Ⅰ～Ⅱ级(A 组,n=30);2.心功能Ⅲ～Ⅳ级(B 组,n=32)。结果表明:1.三组心脏病患者连硬麻醉后心脏指数(CI)、外周血管阻力(SVR)均明显下降,其中Ⅲ组最为明显,新生儿气管插管发生率Ⅲ组(37%)、Ⅰ组(34.5%)均明显高于Ⅱ组(28.5%,P<0.05)。2.心功能 B 组 CI、平均动脉压(MAP)、SVR 下降幅度均明显大于 A 组。新生儿气管插管发生率 B 组(79%)明显高于 A 组(21%,P<0.05)。

In order to enhance anesthesia safety,sixty-two pregnant women with organic heart disease undergoing cesarean section were randomly divided into three groups:1.valvular heart disease(Ⅰ,n=24);2.congenital heart disease-left to right shunt(Ⅱ,n=21);3.congenital heart disease-right to left shunt(Ⅲ,n=17)and also divided into two groups according to preoperative cardiac function i.e.,1.cardiac function Ⅰ-Ⅱ grades(A,n=30);2.cardiac function Ⅲ-Ⅳ(B,n=32). Hemodynamic parameters were monitored during cesarean section by means of Doppler cardicac output monitor.The results showed that 1.Different type heart disease patient cardiac index(CI),and systemic venous resistance(SVR)were significantly decreased in group Ⅱ as compared with group Ⅰ, and Ⅱ.The rates of tracheal intubation of newborn were significantly higher in group Ⅰ and Ⅲ(34.5%,37%)than that in group Ⅱ(26.5%)(P<0.05).2.Regarding to different Cardiac function patients,mean artery pressure(MAP),CI,and SVR were markedly decreased in Group B than that in Group A.The rate of tracheal intubation of newborn was higher in group B in comparison with group A(P<0.05).