全身麻醉对脐血乳酸、S100B、SOD、MDA以及胎盘体视学的影响

发布时间：2018-01-22 15:18

本文关键词： 剖宫产全身麻醉新生儿　出处：《中国病理生理杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的:通过研究全身麻醉(GA)与腰硬联合麻醉(SA)对脐带血乳酸、S100B、超氧化物歧化酶(SOD)活性、丙二醛(MDA)水平以及胎盘体视学的影响,探讨全身麻醉下行剖宫产的安全性以及对新生儿影响。方法:选择50例行择期剖宫产术的单胎足月初产妇,分GA组和SA组,2组均为25例。记录术中产妇的血压、心率以及新生儿1 min及5 min的Apgar评分,比较2组脐动脉血乳酸、血清S100B浓度、SOD与MDA水平,并取胎盘组织对绒毛微血管进行体视学研究。结果:2组术中血流动力学参数、新生儿1 min及5 min的Apgar评分、脐动脉血p H、红细胞压积(Hct)、血红蛋白(Hb)浓度、脐带血血清S100B浓度和胎盘绒毛微血管的长度密度,差异均无统计学意义(P0.05),GA组脐血乳酸浓度和SOD活性较SA组降低,差异有统计学意义(P0.01);GA组脐带血MDA含量和胎盘绒毛微血管体积密度较SA组增加,差异有统计学意义(P0.01)。结论:全身麻醉对剖宫产新生儿安全无明显影响;虽然脐血乳酸以及胎盘绒毛体视学观察结果显示,全身麻醉下行剖宫产对新生儿的氧供有利,但是氧化-抗氧化指标结果显示,全身麻醉有对新生儿产生氧自由基损伤的可能。
[Abstract]:Objective: to study the effects of general anesthesia (GA) and combined spinal-epidural anesthesia (SAA) on the activity of lactic acid S100B and superoxide dismutase (SOD) in umbilical cord blood. To explore the safety of cesarean section under general anesthesia and its influence on newborn. Methods: 50 cases of single term primipara undergoing elective caesarean section were selected to study the effects of malondialdehyde (MDA) and placental stereology. 25 cases were divided into GA group and SA group. The blood pressure, heart rate and the Apgar score of 1 min and 5 min of newborn were recorded during operation, and the umbilical artery blood lactic acid was compared between the two groups. Serum S100B concentration and the levels of sod and MDA were measured, and placental tissues were taken for stereological study of chorionic microvessels. Results Hemodynamic parameters were obtained in two groups. The neonatal Apgar score of 1 min and 5 min, umbilical artery blood pH, hematocrit HCT, hemoglobin Hb). There was no significant difference in serum S100B concentration and length density of placental villus microvessels in cord blood. The lactate concentration and SOD activity of umbilical cord blood in GA group were significantly lower than those in SA group. The difference was statistically significant (P 0.01). The content of MDA in umbilical cord blood and the volume density of placental villi in GA group were significantly higher than those in SA group (P 0.01). Conclusion: general anesthesia has no significant effect on the safety of cesarean section. Although cord blood lactic acid and placental chorionic stereological observations showed that cesarean section under general anesthesia was beneficial to the oxygen supply of newborns, the results of oxidation-oxidation index showed. General anaesthesia may cause oxygen free radical damage in newborns.
【作者单位】：暨南大学附属第一医院麻醉科;暨南大学附属第一医院产科;
【基金】：广东省2012年科技计划(No.2060303)
【分类号】：R614
【正文快照】： 产科麻醉指南推荐剖宫产常规采用椎管内麻醉[1],全身麻醉(general anesthesia,GA)用于产科易发生胎儿窒息,所以目前主要用于有椎管内麻醉禁忌证的产妇。全麻产科中新生儿的安全问题一直是研究热点,虽然已有许多相关的研究[2-3],但观测指标大多依赖Apgar评分,缺乏全面直观的研

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