自然分娩心脏储备观察分析

The explore of cardiac reserve during term delivery

目的运用运动心力检测仪,观察自然分娩中心脏储备变化和心脏安全性评估。方法 53例足月妊娠临产妇女,年龄20～42岁,孕周(39±1.9)周,测量及计算临产前,潜伏期、活跃期、第二产程、第三产程及产后30min内心率、第一心音幅值与第二心音幅值比值(S1/S2)、舒张期与收缩期比值(D/S)。结果临产后心率逐渐增加,与临产前比较差异均有统计学意义(P<0.05),第二产程增幅最多,产后开始恢复。临产后S1/S2逐渐升高,与临产前比较差异均无统计学意义(P>0.05),产后开始恢复。D/S于临产后逐渐降低,与临产前比较差异均无统计学意义(P>0.05),产后即刻未恢复。结论足月妊娠妇女临产后,动用了心率储备及心力储备,表现明显动用了心率储备,即心率增加;心力储备表现为心力幅值增大,由于心率增加,心脏自身供血时间缩短。自然分娩过程中59次/min<心率<100次/min,D/S≥0.9,S1/S2<4.44范围内,无心脏意外事件发生,运用运动心力检测仪观察自然分娩中产妇心脏储备变化,对临产后妇女心脏安全性有一定预测作用。

Objective To explore the cardiac reserve and cardiac safety with sport cardiac contractility monitor during term delivery.Methods There are fifty-three term delivery women with（39±1.9）weeks,20～42years old.The heart rate（HR） and the ratio of the amplitude of the first heart sound to the second heart sound（S1/S2）,the ratio of the diastole to systole（D/S）were measured before delivery、preclinical、acceleration phase、second stage of labor、third stage of labor and 30 minetes after labor.Results The HR were increased after labor,there were significantly differences（P0.05）,second stage of labor were most increased HR in all phase.S1/S2 rate were rised after labor,there were no significantly differences（P0.05）.D/S rate were decreased after labor,there were no significantly differences（P0.05）.Conclusion The HR and cardiac function reserve were up-regulated after term labor,HR were significantly increased,cardiac contractility reserve were up-regulated.But,myocardial blood flow phase were decreased.59次/minHR100次/min,D/S≥0.9,S1/S24.44,Cardiac accident was not happening during term delivery.A sport cardiac contractility monitor maybe predict cardiac safety during term delivery.