网络首发:2013-09-20,
纸质出版:2013
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不同吸入氧浓度对剖宫产时产妇和新生儿的影响[J]. 中山大学学报(医学科学版), 2013,34(5).
Effects of Different Inspired Oxygen Concentration on Nulliparas and Neonatus during Cesarean Section[J]. Journal of Sun Yat-sen University (Medical Sciences), 2013, 34(5).
【目的】 探讨剖宫产术中不同吸入氧浓度对产妇和新生儿的影响。【方法】 选择30例在腰麻下行剖宫产术的单胎足月初产妇
按随机对照的原则分为3组(n = 10)。Ⅰ组(吸空气)
Ⅱ组(吸体积分数为30%O2)
Ⅲ组(吸体积分数比为50% O2)
术中监测并记录血压、心率、血氧饱和度的变化。比较3组新生儿1min及5min的Apgar评分
脐带血血清S100B浓度、乳酸值、血气的变化
取胎盘组织进行免疫组化、染色
利用体视学的方法对绒毛微血管体视学进行研究。 【结果】 3组患者心率
收缩压
血氧饱和度组间比较皆无统计学差异(P > 0.05);3组新生儿1 min及5 min的Apgar评分、脐动脉血pH、PaCO2、PaO2、Hct、Hb、脐带血血清S100B浓度比较差异皆无统计学意义(P > 0.05);Ⅲ组脐血乳酸值与Ⅰ、Ⅱ组相比显著降低
差异有统计学意义(P < 0.05);3组胎盘绒毛微血管的长度密度差异无统计学意义(P > 0.05)
但胎盘绒毛微血管体积密度Ⅲ组与Ⅰ、Ⅱ组相比显著增加
差异有统计学意义(P < 0.05)。【结论】 在腰麻下行剖宫产术中
围术期吸体积分数为30%和50%的氧组与空气组相比都能增加产妇及新生儿的氧含量
从而证明了产妇吸氧的必要性
通过3组乳酸值和胎盘体积密度的比较
围术期吸体积分数比为50%的氧浓度略优于吸30%的氧浓度
但是考虑到有氧自由基的损伤
故推荐围术期吸入30%的氧浓度。
【Objective】 To explore the effects of different inspired oxygen concentration on nulliparas and neonatus during Cesarean Section. 【Methods】 30 cases of full-term women undergoing elective cesarean delivery
after admission were randomly allocated to Ⅰ
Ⅱ
Ⅲ(10 in each). I was given air group
Ⅱ was given 30% oxygen group
Ⅲ was given 50% oxygen group. Blood pressure
heart rate differences at perioperation were record. The Apgar scoring
the concentration of the protein S100B in serum
UCBLAV and difference in blood gas at 1 min and 5 min of 3 group of neonatuses were compared. The placental tissue near the umbilical cord for immunohistochemical staining were extracted. The placental villous capillaries were measured using stereological method. 【Results】 Among 3 groups of patients
differences of HR
SBP
and SpO2 were not statistically significant (P > 0.05). Among 3 groups of neonatuses
differences of the Apgar scoring
pH
PaCO2
PaO2
Hct and Hb of umbilical arterial blood taken at 1 min and 5 min
the concentration of the protein S100B in serum were not statistically significant (P > 0.05). Among 3 groups of patients
UCBLAV
volume and density of placental capillaries of III was higher than Ⅰ and Ⅱ
with statistical significance (P < 0.05); while difference of the length of placental capillaries was not statistically significant (P > 0.05). 【Conclusion】 During perioperation
different inspired oxygen concentration increase in oxygen content. breathing 30% and 50% concentration of oxygen could similarly increase fetal oxygenation but cause a concomitant increase in oxygen free radical activity in neonatus
therefore it is recommended for breathing 30% concentration of oxygen during perioperative cesarean section.
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