仰卧位低血压综合征对剖宫产术产妇妊娠结局的影响

Effect of supine hypotension syndrome on pregnancy outcome of puerperas with cesarean section

  • 摘要: 目的 探讨仰卧位低血压综合征对剖宫产术产妇妊娠结局的影响。 方法 将94例剖宫产术产妇根据是否发生低血压分为观察组和对照组,每组47例。对照组收缩压≥100 mmHg, 观察组收缩压<100 mmHg。观察2组产妇的血气指标,包括碱剩余(BE)、动脉氢离子浓度指数(pH)、动脉血氧分压[pa(O2)]、动脉血二氧化碳分压[pa(CO2)]。比较2组产妇分娩中血压及新生儿Apgar评分。比较2组新生儿的脐动脉及脐静脉血的血气指标变化,以及新生儿脐动脉pH异常率。 结果 2组产妇的血气指标BE、pH、pa(O2)、pa(CO2)比较,差异无统计学意义(P>0.05)。2组产妇胎儿娩出时的收缩压及新生儿Apgar评分比较,差异均无统计学意义(P>0.05); 观察组产妇胎儿娩出前的最低收缩压低于对照组,差异有统计学意义(P<0.05)。2组新生儿脐静脉血和脐动脉血的血气指标BE、pH、pa(O2)、pa(CO2)比较,差异均有统计学意义(P<0.05)。观察组新生儿脐动脉pH≥7.20的异常率低于对照组, pH为7.10~<7.20的异常率高于对照组,差异均有统计学意义(P<0.05)。 结论 剖宫产术中仰卧位低血压综合征可能会导致新生儿高碳酸血症与缺氧,应采取积极措施予以处理,改善母婴结局。

     

    Abstract: Objective To investigate the effect of supine hypotension syndrome on pregnancy outcome of puerperas with cesarean section. Methods Totally 94 puerperas with cesarean section were divided into observation group and control group according to hypotension or not, with 47 cases in each group. The systolic blood pressure of the control group was greater than or equal to 100 mmHg, while that of the observation group was less than 100 mmHg. The blood gas indexes were observed in both groups, including alkali residue(BE), arterial hydrogen ion concentration index(pH), partial pressure of arterial oxygen [pa(O2)], partial pressure of arterial blood carbon dioxide [pa(CO2)]. Blood pressure during delivery and Apgar score of newborns were compared between the two groups. The changes of blood gas indexes of umbilical artery, umbilical vein blood and the abnormal rate of umbilical artery pH were compared between the two groups. Results There were no significant differences in blood gas indexes such as BE, pH, pa(O2)and pa(CO2)in puerperas between the two groups(P>0.05). There were no significant differences in systolic blood pressure at fetal birth and neonatal Apgar score between the two groups(P>0.05). The lowest systolic pressure before fetal birth in the observation group was significantly lower than that in the control group(P<0.05). There were significant differences in BE, pH, pa(O2)and pa(CO2)of umbilical vein and artery blood in newborns between the two groups(P<0.05). The abnormal rate of umbilical artery pH≥7.20 in the observation group was significantly lower than that in the control group, and the abnormal rate of pH value ranged - from 7.10 to less than 7.20 was significantly higher than that in the control group(P<0.05). Conclusion Supine hypotension syndrome during cesarean section may lead to hypercapnia and hypoxia in newborns. Active measures should be taken to improve the maternal and infant outcomes.

     

/

返回文章
返回