晶氧和碳酸氢钠改善第二产程母血酸碱平衡  

Perhydrit and sodium bicarbonate improve maternal gases and acid base status during the second stage of labor

作　　者：张陵娜[1] 刘蓉[1] 

机构地区：[1]附属湘雅医院妇产科,长沙410008

出　　处：《湖南医科大学学报》1999年第5期468-470,共3页Bulletin of Hunan Medical University

基　　金：湖南省科委重点课题

摘　　要：对９９ 例经阴道分娩的产妇于第二产程开始时给予鼻导管吸氧，静脉滴注碳酸氢钠、过氧化氢碳酸酰胺（ 晶氧） ，于第二产程始末两次采母桡动脉血行血气分析。结果显示：晶氧碳酸氢钠联用组（ Ⅰ组）于第二产程结束时其ｐＨ，ＢＥ，ＰＯ２ 及Ｏ２ｓａｔ均显著高于对照组（ Ⅲ组）（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） ，而ＰＯ２ 及Ｏ２ｓａｔ则无统计学差异；Ⅰ组与Ⅱ组ｐＨ，ＰＯ２ 及Ｏ２ｓａｔ 值于第二产程末较开始时显著升高（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） ，ＢＥ 在该产程始末无统计学差异；Ⅲ组上述４ 指标明显下降（ Ｐ ＜ ０ ．０５ 和＜ ０ ．０１） 。各组间及组内比较ＰＣＯ２ 均无明显变化。提示第二产程中常规给予纠酸，吸氧内给氧能有效地改善产妇过度消耗所致的酸中毒和缺氧倾向。Perhydrit and sodium bicarbonate were administered to 99 women during the second stage of labor. Gas analysis was done twice at the beginning and the end of the second stage. The results showed that 33 women received both perhydrit and sodium bicarbonate(Group Ⅰ) had significantly higher pH, BE, pO 2, and O 2sat at the end of the second stage than those of 30 controls(Group Ⅲ)(P<0.05 and <0.01). And 33 women received only sodium bicarbonate(Group Ⅱ) showed merely higher pH and BE than those of Group Ⅲ. The difference was significant(P<0.05 and <0.01), while PO 2 and O 2sat had no statistical difference between Group Ⅱ and Group Ⅲ. By comparing the values, we found that pH, PO 2 and O 2sat were much higher at the end of the second stage in Group Ⅰ and Group Ⅱ than those at the beginning of the second stage(P<0.05 and<0.01). No statistical difference of BE had been found between both groups. In contrary, BE, pH, PO 2 and O 2sat declined at the end of the second stage in Group Ⅲ (P<0.02 and <0.01). There were no significant differences of PCO 2 among the three groups. It is suggested that the administration of perhydrit and sodium bicarbonate may effectively improve the tendency of maternal metabolic acidosis and tissue oxygen debt caused by consumption and uterine contractions during the second stage, subsequently improve maternal gases and acid base status.

关 键 词：分娩 产程 第二产程 晶氧 碳酸氢钠 血气分析 

分 类 号：R714.3[医药卫生—妇产科学]