不同麻醉方法在胎窘时施行急症剖宫产对脐动脉血气的影响

Effect of Different Anesthetic Method on Blood Gas of Umbilical Artery during Urgent Cesarean Delivery for Fetal Distress

目的:观察不同麻醉方法在胎窘时施行急症剖宫产对脐动脉血气的影响。方法:选择美国麻醉医师协会病情估计分级（ASA）1级已诊断为胎儿宫内窘迫的剖宫产孕产妇40例,分为腰麻（SA）组20例和连续硬膜外（CEA）组20例。在胎儿娩出后立即抽取新生儿脐动脉血进行血气分析。结果:SA组脐动脉血气的pH、PO2明显高于CEA组（P<0.01）,SA组的PCO2明显低于CEA组（P<0.01）,两组BE、HCO3-1无显著性差异（P>0.05）。结论:对急症剖宫产尤其有胎儿宫内窘迫者选择腰麻较硬膜外麻醉对新生儿更为有利。

Objective: To investigate the effect of different anesthetic method on blood gas of umbilical artery during urgent cesarean delivery for fetal distress. Methods: Forty preterm parturients for fetal distress(ASA grade 1)were randomly divided into two groups: spinal anesthesia (SA) group (n=20) and continuous epidural anes-thesia(CEA) group(n =20). The sample of umbilical artery blood was taken for measurement of blood gas at once after delivery. Results: The pH and PO2 of umbilical artery blood in SA group were markedly higher than those in CEA group(P<0.01) .The PCO2 of umbilical artery blood in SA group were markedly lower than those in CEA group(P<0.01). There was not any significant difference between the two groups in BE and HCO3 of umbilical artery blood(P>0.05) .Conclusion: It is better for newborn to perform SA, especially during urgent cesarean delivery for fetal distress.