剖宫产产妇腰麻后应用低血压综合征预防托架对新生儿脐血血气指标的影响

Effect of the application of bracket for preventing supine hypotention syndrome on umbilical blood gas of fetus during cesarean section

目的观察剖宫产产妇术中腰麻后应用仰卧位低血压综合征预防托架(以下简称托架)对新生儿脐血血气的影响。方法选择ASAⅠ～Ⅱ级120例择期在腰麻下行剖宫产的产妇,随机分为观察组和实验组,各60例。对照组孕妇麻醉后手术床左倾150,实验组麻醉后应用托架。胎儿娩出尚未出现第1次呼吸之前用两把血管钳钳夹一段脐带,抽取脐动脉、脐静脉血行血气分析。结果实验组脐动脉血pH、PO2、PCO2、BE、HCO3-分别为7.28±0.06、(15.93±4.41)mmHg、(47.25±8.52)mmHg、(-4.05±2.50)mmol/mL、(23.13±4.28)mmol/mL,脐静脉血分别为(7.31±0.06)、(21.28±4.24)mmHg、(42.59±7.72)mmHg、(-4.73±1.93)mmol/mL、(21.90±3.46)mmol/mL;对照组脐动脉血分别为7.24±0.08、(14.57±5.08)mmHg、(51.01±12.49)mmHg、(-5.03±2.00)mmol/mL、(23.62±8.60)mmol/mL。实验组新生儿脐动脉、脐静脉血pH、BE与对照组相比P均<0.05。对照组7例新生儿脐动脉血pH<7.15,实验组无脐动脉血pH<7.15者,两组脐动脉血pH<7.15发生率相比P<0.05。结论剖宫产术中腰麻后应用托架能升高新生儿脐动静脉pH和BE,预防新生儿酸中毒。

Objective To investigate the effect of the application of bracket for preventing supine hypotention syndrome on umbilical blood gas of fetus（hereinafter referred to as uterine bracket） after spinal anesthesia during cesarean section.Method 120 ASA I or Ⅱ parturients underwent cesarean section under spinal anesthesia and were randomly divided into two groups.The control group of pregnant women after spinal anesthesia made operating table 150 left-leaning,experimental group after spinal anesthesia applicated the bracket.Umbilical blood was taken before the first time of new-born breath for blood gas analysis.The time intervals from spinal anesthesia to skin incision and from uterine incision were recorded.Results In experimental group,pH、PO2,PCO2,BE,HCO-3 were 7.28±0.06,（15.93±4.41）mmHg,（47.25±8.52）mmHg,（-4.05±2.50）mmol/mL,（23.13±4.28）mmol/mL in umbilical artery;and（7.31±0.06）,（21.28±4.24）mmHg,（42.59±7.72）mmHg,（-4.73±1.93）mmol/mL,（21.90±3.46）mmol/mL in umbilical vein;but 7.24±0.08,（14.57±5.08）mmHg,（51.01±12.49）mmHg,（-5.03±2.00）mmol/mL,（23.62±8.60）mmol/mL in umbilical artery of control group.The control group of pH 7.15 were seven cases,but uterine bracket group were zero（P〈0.05）.Conclusion The application of uterine bracket after spinal anesthesia for cesarean section can make umbilical blood gas of newborns be less affected.