脐血pH值联合SpO_2检测观察七氟醚辅助硬膜外阻滞对剖宫产新生儿的影响

Observe the Affection of Cesarean Section Infants Using Sevoflurane Inhalation of Epidural Anesthesia by Umbilical Cord Blood pH Combined with SpO_2 Measurement

目的通过对新生儿脐血pH值及脉搏氧饱和度（spO2）数值进行采集并综合分析，探讨低浓度七氟醚密闭吸入辅助硬膜外阻滞对剖宫产新生儿的安全影响。方法选取2010年12月-2011年10月期间的90例因社会因素行剖宫产手术患者，ASA分级Ⅰ级，随机分为对照组（A组）和七氟醚组（B纽），每组45例，均常规行硬膜外穿刺置管，成功后注入局麻药试验量，测得麻醉平面后，A组密闭面罩吸入相同浓度氧气而B组吸入研究剂量的七氟醚，两组均硬膜外常规用药。胎，乙娩出后取哜血进行pH值测定，同时记录新生儿1min，5min Apgar评分及新生儿SpO2，并进行相关性分析。结果脐血血气分析，两组脐静脉血的pH值、新生儿Apgar评分及SpO2差异无显著性。手术开始到胎儿娩出时间两组比较差异有显著性（P〈0．01），即对产妇麻醉效果的评价，B组明显优于A组。结论应用荆量七氟醚作为硬膜外麻醉下行剖宫产术的辅助吸入用药，效果安全确切，对新生儿无明显不良反应，脐血pH值联合SpO2监测可反映新生儿窒息程度，比Apgar评分更灵敏、准确，有利于早期判断病情，指导临床用药。

Objective To explore the security impact of cesarean section infants using low concentration sewdlurane inhalation closed epidural anesthesia by collection and comprehensive analysis of the numerical cord blood pH values and pulse oxygen saturation （SpO2 ）. Methods Ninety cesarean surgery patients due to social factors from October 2010 to October 2011 were selected,all in ASA [ lev- el, and randomly divided into the control group（ group A,n = 45） and sevoflurane group （group B,n = 45）. Routine epidural puncture,injec- ting local anesthetics after successfully test, both group were measured after the anesthetic plane. The same concentration of oxygen was pro- vided in group A by tbe set of airtight mask and dose sevoflurane inhalation study was carried on in group B,both groups were given the con- ventional medicine in epidural. After delivery cord blood pH value,recording 1 rain,5 min of newborn,Apgar score and pulse oxygen satura- tion in neonates（SpO：） was determined and torrelation analysis was took. Results Umbilical vein pH value,neonatal Apgar score and tile pulse oxygen saturation in two groups had no significant differences. Duration between surgery, and fetal childbirth in two groups was signifi- cant difference, namely the puerpera anaesthetie effect evaluation in group B was obviously better than in group A. Conclusion The effect of Dose sevofhu＇ane as auxiliary vein drug combined with peridural anesthesia in cesarean section is exactly a safe method,and for newborns have no obvious adverse reactions. Umbilical cord blood pH value and pulse oxygen saturation （ SpO2 ） may reflect neonatal asphyxia degree, which are more sensitive and accurate than Apgar score,and can be helpful in early judgment of illness and guiding clinical medication.