先天性心脏病产妇剖宫产术中的母婴脐带血血气分析

发布时间：2018-02-25 03:18

本文关键词： 腰硬联合麻醉妊娠合并先天性心脏病脐带血气　出处：《上海交通大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景：妊娠合并心脏病是中国孕产妇非直接产科死因的第1位，妊娠合并先天性心脏病的产妇，其胎儿和新生儿的并发症发生率和死亡率很高。但目前并没有确切研究表明，在择期的腰硬联合麻醉（CSE）剖宫产手术中，合并先心病的产妇和健康产妇，两者的脐带血血气值有无差异。本研究，，意在比较两者的脐带血酸碱状态和血气值。方法：我们选择宫内足月单胎妊娠的择期腰硬联合麻醉（CSE）下的剖宫产手术患者。将病例分为两组：健康产妇组（H组）和合并先天性心脏病的产妇组（CHD组）。胎儿娩出后即刻，抽取脐动、静脉血并行血气分析。血气值采用分组t检验分析。结果：H组44名产妇和CHD组33名产妇最终入组。CHD组的脐动脉血pH，BE和HCO-3(pH7.29±0.05，BE-1.4±1.9mmol/L，HCO-321.5±1.4mmol/L)明显低于H组(pH7.33±0.03，BE-0.1±2.1mmol/L，HCO-322.5±1.4mmol/L)。结论：脐动脉血pH，BE和HCO-3在妊娠合并先天性心脏病的产妇接受腰硬联合麻醉下择期剖宫产时，明显低于健康产妇。
[Abstract]:Background: pregnancy complicated with heart disease is China maternal non direct obstetric death first, congenital heart disease with pregnancy women, the fetal and neonatal morbidity and mortality is very high. But there is no exact research shows that in the elective spinal epidural anesthesia (CSE) cesarean section, maternal congenital heart disease with and maternal health, there is no difference between the umbilical cord blood gas values. This study aims to compare the umbilical cord blood pH and blood gas values.
Methods: We selected full-term singleton pregnancies undergoing intrauterine combined spinal epidural anesthesia (CSE) in cesarean section patients. The patients were divided into two groups: healthy parturient group (H group) and congenital heart disease with maternal group (group CHD). Immediately after delivery of fetus, umbilical artery blood gas extraction. Analysis of blood gas values in parallel. Using group t test analysis.
Results: in group H, 44 maternal and CHD group 33 puerperal women were finally enrolled in group.CHD, and the umbilical artery blood pH, BE and HCO-3 (pH7.29 + 0.05, BE-1.4 + 1.9mmol/L, HCO-321.5 + 1.4mmol/L) were significantly lower than those in the group of.CHD.
Conclusion: the umbilical artery blood pH, BE and HCO-3 in pregnant women with congenital heart disease undergoing selective cesarean section under combined spinal epidural anesthesia are significantly lower than those of healthy mothers.

【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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