本文關(guān)鍵詞： 剖宮產(chǎn) 全身麻醉 新生兒　出處：《中國病理生理雜志》2015年02期 　論文類型：期刊論文

【摘要】：目的:通過研究全身麻醉(GA)與腰硬聯(lián)合麻醉(SA)對(duì)臍帶血乳酸、S100B、超氧化物歧化酶(SOD)活性、丙二醛(MDA)水平以及胎盤體視學(xué)的影響,探討全身麻醉下行剖宮產(chǎn)的安全性以及對(duì)新生兒影響。方法:選擇50例行擇期剖宮產(chǎn)術(shù)的單胎足月初產(chǎn)婦,分GA組和SA組,2組均為25例。記錄術(shù)中產(chǎn)婦的血壓、心率以及新生兒1 min及5 min的Apgar評(píng)分,比較2組臍動(dòng)脈血乳酸、血清S100B濃度、SOD與MDA水平,并取胎盤組織對(duì)絨毛微血管進(jìn)行體視學(xué)研究。結(jié)果:2組術(shù)中血流動(dòng)力學(xué)參數(shù)、新生兒1 min及5 min的Apgar評(píng)分、臍動(dòng)脈血p H、紅細(xì)胞壓積(Hct)、血紅蛋白(Hb)濃度、臍帶血血清S100B濃度和胎盤絨毛微血管的長(zhǎng)度密度,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),GA組臍血乳酸濃度和SOD活性較SA組降低,差異有統(tǒng)計(jì)學(xué)意義(P0.01);GA組臍帶血MDA含量和胎盤絨毛微血管體積密度較SA組增加,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:全身麻醉對(duì)剖宮產(chǎn)新生兒安全無明顯影響;雖然臍血乳酸以及胎盤絨毛體視學(xué)觀察結(jié)果顯示,全身麻醉下行剖宮產(chǎn)對(duì)新生兒的氧供有利,但是氧化-抗氧化指標(biāo)結(jié)果顯示,全身麻醉有對(duì)新生兒產(chǎn)生氧自由基損傷的可能。
[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.
【作者單位】： 暨南大學(xué)附屬第一醫(yī)院麻醉科;暨南大學(xué)附屬第一醫(yī)院產(chǎn)科;
【基金】：廣東省2012年科技計(jì)劃(No.2060303)
【分類號(hào)】：R614
【正文快照】： 產(chǎn)科麻醉指南推薦剖宮產(chǎn)常規(guī)采用椎管內(nèi)麻醉[1],全身麻醉(general anesthesia,GA)用于產(chǎn)科易發(fā)生胎兒窒息,所以目前主要用于有椎管內(nèi)麻醉禁忌證的產(chǎn)婦。全麻產(chǎn)科中新生兒的安全問題一直是研究熱點(diǎn),雖然已有許多相關(guān)的研究[2-3],但觀測(cè)指標(biāo)大多依賴Apgar評(píng)分,缺乏全面直觀的研

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