腰-硬联合麻醉对剖宫产产妇呼吸参数的影响  

Effects of combined spinal-epidural anesthesia on respiratory parameters in parturient women undergoing cesarean section

作　　者：胡清刚[1] 郝建华[1] 杨红明[2] 李平[1] 李萌萌[1] 

机构地区：[1]解放军总医院第一附属医院麻醉科,北京100048 [2]解放军总医院第一附属医院烧伤整形科,北京100048

出　　处：《感染．炎症．修复》2009年第4期231-233,共3页Infection Inflammation Repair

摘　　要：目的:探讨腰-硬联合麻醉对剖宫产产妇呼吸功能的影响。方法:30例美国麻醉医师学会(ASA)Ⅰ～Ⅱ单胎足月孕妇,在腰-硬联合麻醉下行剖宫产术,用面罩紧闭法测量孕妇在入室后平卧位(T_0),麻醉完成后仰卧即刻(T_1)、5 min(T_2)、10 min(T_3),胎儿取出后1 min(T_4)、5min(T_5)和10 min(T_6)时的呼吸频率(RR)、潮气量(V_T)、分钟通气量(V_E)、呼气末二氧化碳分压(P_(ET)CO_2)、1秒率(V_(1.0))、呼吸比(E∶I)等参数的变化。结果:与基础值(T_0)相比较,P_(ET)CO_2于各个观察时间点均明显降低(P<0.01);T_1、T_2、T_6时V_E明显降低;T_1时的V_T亦降低(P<0.05)。结论:腰-硬联合麻醉能使剖宫产产妇的V-E、P_(ET)CO_2明显降低,缓解产妇的过度通气,降低其氧耗量,且不会对产妇呼吸功能产生不利影响。Objective： To investigate the influence of combined spinal-epidural anesthesia on respiratory function of parturients undergoing cesarean section. Methods： Thirty American Society of Anesthesiologist （ASA） Ⅰ-Ⅱ parturients undergoing cesarean section with combined spinal-epidural anesthesia, were given 6 L/min oxygen with facemask after entering operation room. The changes in respiratory rate （RR）, vital volume （VT）, minute ventilation （VE）, and expiratory partial pressure of CO2 （PET CO2 ）, expiratory volume ratio （V1.0） were determined at time of putting the patient in supine position （T0） and the moment after the induction of anesthesia （T1）, 5 minutes （T2） and 10 minutes （T3） after anesthesia,and 1 minute （T4） ,5 minutes （T5）, 10 minutes （T6） after delivery of the fetus. Results： Compared with that of To, the VT, VE ,PETCO2 of T1 -T6 ,the PETCO2 of T1-6 ,the VE of T1 ,T2 ,T6 decreased significantly（P〈0.01） ;the VT of T1 was also decreased （P〈0. 05）. Conclusion： Combined spinal-epidural anesthesia significantly decreases the VE ,PETCO2 of parturients undergoing cesarean section, thus palliating the state of byperventilation, therefore it does not give rise any disadvantages to respiratory function of parturients.

关 键 词：腰麻 硬膜外麻醉 剖宫产术 呼吸功能 

分 类 号：R719.8[医药卫生—妇产科学] R174.4[医药卫生—临床医学]