产科围术期子痫前期急性肺水肿的临床干预研究  

Perioperative intervention on acute pulmonary edema in severe preeclampsia patients

作　　者：李智泉[1] 王晨虹[1] 肖立[1] 周紫琼 

机构地区：[1]南方医科大学深圳市妇幼保健院,518028

出　　处：《中国计划生育学杂志》2010年第5期295-298,共4页Chinese Journal of Family Planning

摘　　要：目的:通过产科围术期干预,降低子痫前期急性肺水肿的发生率。方法:选择本院产科68例重度子痫前期剖宫产者,随机分为干预组(33例)和对照组(35例),对照组给予解痉治疗,干预组在此基础上于产后予利尿治疗,比较两组手术前后血氧饱和度、呼吸频率、心率、平均动脉压及围术期急性肺水肿发生率等指标。结果:干预组术后血氧饱和度(98.30±1.40)%与对照组(93.57±2.76)%相比,差异有统计学意义(P<0.05)。干预组术后呼吸频率及心率分别为19.61±1.73次/分、85.33±11.98次/分,均低于对照组的23.17±3.97次/分、104.31±13.11次/分,差异有统计学意义(P<0.05)。干预组术后尿量为248.45±32.76ml/h,明显多于对照组的97.20±26.49ml/h(P<0.01)。干预组术后平均动脉压为102.79±9.58mmHg,比对照组的117.06±8.20mmHg明显下降(P<0.05)。干预组术后胶体渗透压为17.66±3.17mmHg,明显高于对照组的13.65±4.17mmHg,差异有统计学意义(P<0.05)。干预组围术期急性肺水肿发生率为3.03%,明显低于对照组的19.44%(P<0.05)。结论:通过围术期干预治疗,可改善子痫前期剖宫产者肺功能,降低急性肺水肿的发生率。Objective：To reduce the incidence of acute pulmonary edema by perioperative intervention on acute pulmonary edema in preeclampsia patients.Methods：Sixty-eight patients with severe preeclampsia who planned to experience a cesarean delivery were randomly divided into the intervention group（n=33）and the control group（n=35）.During the perioperative period,the patients in the control group were given magnesium sulfate.Besides this spasmolytic drug,the patients in the intervention group were given diuretic treatment after delivery.The oxyhemoglobin saturation,respiratory rate,heart rate,mean arterial pressure（MAP）and the incidence of acute pulmonary edema were compared between the two groups.Results：After delivery,there was significant difference in oxyhemoglobin saturation between the two groups（98.30%±1.40% vs 93.57%±2.76%,P0.05）;the respiratory rate and heart rate in intervention group [（19.61±1.73）and（85.33±11.98）beats per minute（bpm）] were lower than those of the control group [（23.17±3.97）and（104.31±13.11）bpm,P0.05];the total volume of accumulated urine in the intervention group was more than that in the control group [（248.45±32.76）ml/h vs（97.20±26.49）ml/h,P0.01];the MAP in the intervention group postpartum was significantly lower than that in the control group[（102.79±9.58）mmHg vs（117.06±8.20）mmHg,1mmHg=0.133kPa,P0.05],the colloid osmotic pressure in the intervention group was significantly higher than that in the control group [（17.66±3.17）mmHg vs（13.65±4.17）mmHg,P0.05].The incidence of acute pulmonary edema in the intervention group（3.03%）was lower than that in the control group（19.44%）,showing the statistically significant difference（P0.05）.Conclusion：The perioperative intervention on acute pulmonary edema in the severe preeclampsia patients can significantly improve their lung function and reduce the incidence of acute pulmonary edema.

关 键 词：重度子痫前期 肺水肿 围手术期 干预 产科 

分 类 号：R714.245[医药卫生—妇产科学]