七氟醚吸入辅助硬膜外阻滞麻醉对剖宫产新生儿的影响
发布时间：2019-06-18 11:59
【摘要】：目的：通过对新生儿脐血pH值及脉搏氧饱和度(Sp02)进行采集并分析,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性影响。 方法：选取2011年10月-2012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组),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。胎儿娩出后取脐血进行血气分析及乳酸测定,同时记录新生儿lmin、5min Apgar评分及新生儿动脉氧饱和度(Sp02),进行相关性分析。 结果： (1)A组娩出前胎儿心率(bpm)140.1±8.4,娩出后心率为141.2±8.5,波动范围为1.1±0.1；B组娩出前胎儿心率139.7±7.7,娩出后心率为140.7±8.7,波动范围为1.0±1.0。两组相比无显著性差异(P0.05)。 (2)脐血血气分析脐动脉血pH测值A组7.26±0.07,B组7.25±0.07,两组相比无显著性差异(P0.05)；B组脐静脉血的pH值为7.30±0.08,略低于A组的7.32±0.06,但亦无显著性差异(P0.05)。 (3)新生儿Apgar评分A组分别为lmin时8.9±1.8(分),5min时9.5±1.5；B组分别为lmin时8.8±2.8,5min时9.2±1.1。两组相同时间点之间比较无显著性差异(P0.05)。 (4)Sp02(%)A组分别为lmin时97.5±3.5,5min时98.2±4.4；B组分别为imin时97.2±4.5,5min时98.5±3.6。两组相同时间点之间比较无显著性差异(P0.05)。 (5)手术开始到胎儿娩出时间(min)A组为8.8±1.7,B组为7.1±1.4,两组差异有统计学意义(P0.01),即观察两组对剖宫产手术时间方面的影响,B组明显优于A组。 结论：应用剂量七氟醚作为硬膜外麻醉下行剖宫产术的辅助吸入用药,与非应用组对比效果确切(缩短了胎儿剖出时间及手术时间),从Apgar评分、脐血pH值及Sp02监测等多个生命指标观察无显著性差异,即对新生儿无明显不良反应,为剖宫产手术麻醉方式提供了更多选择。
[Abstract]:Objective: to investigate the safety of cord blood pH value and pulse oxygen saturation (Sp02) in neonates undergoing cesarean section by collecting and analyzing the pH value and pulse oxygen saturation (PBO) of neonatal umbilical cord blood and exploring the safety of low concentration sevoflurane closed inhalation assisted epidural block. Methods: from October 2011 to October 2012, 90 patients undergoing cesarean section due to social factors were randomly divided into control group (group A) and sevoflurane group (group B) with 45 cases in each group. All the patients were given epidural puncture and catheterization, and the local anesthetic test was injected successfully. After the anesthesia plane was measured, the closed mask in group A inhaled the same concentration of oxygen, while group B inhaled sevoflurane in the study dose, and both groups were given routine epidural medication. Umbilical cord blood was taken for blood gas analysis and lactic acid determination after delivery. Neonatal lmin,5min Apgar score and neonatal arterial oxygen saturation (Sp02) were recorded for correlation analysis. Results: (1) in group A, the fetal heart rate was 140.1 卤8.4 before delivery, 141.2 卤8.5 after delivery, and the fluctuation range was 139.7 卤7.7 in group B, 140.7 卤8.7 and 1.0 卤1.0 in group B before delivery. There was no significant difference between the two groups (P 0.05). (2) there was no significant difference in umbilical artery blood pH between group A (7.26 卤0.07) and group B (7.25 卤0.07). There was no significant difference between the two groups (P 0.05). The pH value of umbilical vein blood in group); B was 7.30 卤0.08, which was slightly lower than that in group A (7.32 卤0.06), but there was no significant difference between the two groups (P 0.05). (3) the neonatal Apgar score in group A was 8.9 卤1.8 at lmin, 9.5 卤1.5 for 5min, 8.8 卤2.8 for lmin and 9.2 卤1.1 at 5 min, respectively. There was no significant difference between the two groups at the same time point (P 0.05). (4) Sp02 (%) A group was 97.5 卤3.5 at lmin, 98.2 卤4.4 in group B at 5 min, 97.2 卤4.5 in group B and 98.5 卤3.6 at 5 min, respectively. the results showed that lmin was 97.5 卤3.5 in group A, 98.2 卤4.4 in group B at 5 min, and 98.5 卤3.6 in group B at 5 min. There was no significant difference between the two groups at the same time point (P 0.05). (5) the time from the beginning of operation to fetal delivery was 8.8 卤1.7 in (min) A group and 7.1 卤1.4 in group B. There was significant difference between the two groups (P 0.01). The effect of the two groups on the operation time of cesarean section was significantly better in group B than in group A. Conclusion: the application of sevoflurane as auxiliary inhaled drug for cesarean section under epidural anesthesia is effective compared with the non-application group (shortening the time of fetal caesarean section and operation time). There is no significant difference in Apgar score, umbilical cord blood pH value and Sp02 monitoring, that is to say, there is no obvious adverse reaction for neonates, which provides more options for anesthesia of cesarean section.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R614
本文编号：2501469
[Abstract]:Objective: to investigate the safety of cord blood pH value and pulse oxygen saturation (Sp02) in neonates undergoing cesarean section by collecting and analyzing the pH value and pulse oxygen saturation (PBO) of neonatal umbilical cord blood and exploring the safety of low concentration sevoflurane closed inhalation assisted epidural block. Methods: from October 2011 to October 2012, 90 patients undergoing cesarean section due to social factors were randomly divided into control group (group A) and sevoflurane group (group B) with 45 cases in each group. All the patients were given epidural puncture and catheterization, and the local anesthetic test was injected successfully. After the anesthesia plane was measured, the closed mask in group A inhaled the same concentration of oxygen, while group B inhaled sevoflurane in the study dose, and both groups were given routine epidural medication. Umbilical cord blood was taken for blood gas analysis and lactic acid determination after delivery. Neonatal lmin,5min Apgar score and neonatal arterial oxygen saturation (Sp02) were recorded for correlation analysis. Results: (1) in group A, the fetal heart rate was 140.1 卤8.4 before delivery, 141.2 卤8.5 after delivery, and the fluctuation range was 139.7 卤7.7 in group B, 140.7 卤8.7 and 1.0 卤1.0 in group B before delivery. There was no significant difference between the two groups (P 0.05). (2) there was no significant difference in umbilical artery blood pH between group A (7.26 卤0.07) and group B (7.25 卤0.07). There was no significant difference between the two groups (P 0.05). The pH value of umbilical vein blood in group); B was 7.30 卤0.08, which was slightly lower than that in group A (7.32 卤0.06), but there was no significant difference between the two groups (P 0.05). (3) the neonatal Apgar score in group A was 8.9 卤1.8 at lmin, 9.5 卤1.5 for 5min, 8.8 卤2.8 for lmin and 9.2 卤1.1 at 5 min, respectively. There was no significant difference between the two groups at the same time point (P 0.05). (4) Sp02 (%) A group was 97.5 卤3.5 at lmin, 98.2 卤4.4 in group B at 5 min, 97.2 卤4.5 in group B and 98.5 卤3.6 at 5 min, respectively. the results showed that lmin was 97.5 卤3.5 in group A, 98.2 卤4.4 in group B at 5 min, and 98.5 卤3.6 in group B at 5 min. There was no significant difference between the two groups at the same time point (P 0.05). (5) the time from the beginning of operation to fetal delivery was 8.8 卤1.7 in (min) A group and 7.1 卤1.4 in group B. There was significant difference between the two groups (P 0.01). The effect of the two groups on the operation time of cesarean section was significantly better in group B than in group A. Conclusion: the application of sevoflurane as auxiliary inhaled drug for cesarean section under epidural anesthesia is effective compared with the non-application group (shortening the time of fetal caesarean section and operation time). There is no significant difference in Apgar score, umbilical cord blood pH value and Sp02 monitoring, that is to say, there is no obvious adverse reaction for neonates, which provides more options for anesthesia of cesarean section.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R614
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