接受无痛性早期妊娠终止术患者的心力储备无创检测和安全性评估分析

Safety Evaluation and Non-Invasive Detection of Cardiac Reserve During Painless Early Pregnancy Termination Surgery

目的评估接受无痛性早期妊娠终止术患者的心力储备无创检测和安全性。方法选择2007年2月至2008年2月在本院就诊的179例要求终止妊娠,自愿选择无痛性早期妊娠终止术的妊娠妇女为研究对象。其年龄为20～40岁,妊娠时间为(8.0±1.9)孕周。采取测量及计算无痛性早期妊娠终止术麻醉前、后及术中,心率、第一心音幅值对第二心音幅值比值(ratio of the amplitude of the first heart sound and the second heart sound,S1/S2)的方法 ,评估接受无痛性早期妊娠终止术患者的心力储备无创检测和安全性(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准和受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果麻醉后,受试者心率增加,手术中,心率降低,与麻醉前比较,差异有显著意义(P<0.05)。麻醉后,心力储备无创检测S1/S2较麻醉前升高,而手术中,S1/S2较麻醉前降低,但差异无显著意义(P>0.05)。结论无痛性早期妊娠终止术麻醉应激时,患者心功能上调,动用心率储备及心力储备;手术中,心功能下调,但无意外事件发生。心力储备无创检测,可预测无痛性早期妊娠终止术中孕妇的安全性。

Objective To explore a non-invasive method for measuring cardiac reserve during painless early pregnancy termination surgery and its safety evaluation.Methods From February 2007 to February 2008,179 pregnant women with 8.0±1.9 weeks,20-40 years old,who chose painless early pregnancy termination surgery were recruited in this study.The heart rate （HR） and the ratio of the amplitude of the first heart sound to the second heart sound （S1/S2） were measured before and after the anesthesia,and during painless early pregnancy termination surgery.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Chengdu Maternal and Child Health Care Hospital.Informed consent was obtained from each participating.Results The heart rates were increased after anesthesia,and decreased during operation.There were significant differences of heart rate between before and after anesthesia,and between after anesthesia and during the operation （P〈0.05）.Ratio of the amplitude of the first heart sound to the second heart sound was raised after anesthesia,a opposite amplitude was found during operating.Nevertheless,there was no significantly differences （P〉0.05）.Conclusion Cardiac function were up-regulated after anesthesia in painless early pregnancy termination surgery.The mobilization were observed in heart rate reserve and cardiac function reserve,there was opposite mobilization during operating.Cardiac accident did not happen.A non-invasive measure of cardiac reserve maybe predict cardiac safety during painless early pregnancy termination surgery.