运动心力监测仪在剖宫产术中的临床应用研究  

The study of clinical application of exercise cardiac contractility monitor in cesarean section

作　　者：李玮[1] 刘德顺[1] 江庆霖[1] 曹蓉[1] 漆洪波[2] 

机构地区：[1]重庆医科大学附属成都妇女儿童中心医院妇产科,四川成都610031 [2]重庆医科大学附属第一医院妇产科,重庆400016

出　　处：《西部医学》2013年第5期663-664,667,共3页Medical Journal of West China

基　　金：四川省卫生厅科研项目(060187)

摘　　要：目的运用运动心力监测仪监测在剖宫产术中心脏储备及心脏安全性,认识剖宫产妇女心脏储备的动用规律。方法 119例足月妊娠妇女,终止妊娠方式为剖宫产,选择联合麻醉,年龄20～42岁,孕周(39±1.1)周,测量及计算剖宫产术麻醉前、麻醉后、手术后、娩胎及手术结束心率、舒张期与收缩期时限比值(D/S),第一心音幅值与第二心音幅值比值(S1∕S2)。结果剖宫产妇女麻醉后、手术后、娩胎及手术结束时均心率增加,手术开始至手术结束心率增加有显著差异(P<0.05)。麻醉后至手术结束患者D/S降低,而S1∕S2升高,分别与麻醉前比较均有显著差异(P<0.05)。结论剖宫产术中麻醉开始即动用心率储备、心肌收缩能力储备及舒张期储备,手术结束心脏功能开始恢复,但无心脏意外事件发生。运动心力监测仪可检测剖宫产术中妇女心脏储备,可预测其安全性。Objective To explore cardiac reserve and cardiac safety in exercise cardiac contractility monitor during cesarean section, and the regularity of cardiac reserve in cesarean section. Methods There are one hundred nineteen preg- nant women 20-42 years old with 39±1.1 pregnent weeks. They chose a cesarean section. The heart rate（HR）, the ratio of the amplitude of the first heart sound to the second heart sound（S1/S2） and the ratio of the diastolic to systolic （D/S） were measured before anesthesia,during anesthesia, in operation, delivery fetus and finished operation. Results The HR and S1 / S2 ratio were increased after anesthesia, the D/S ratio were decreased. The HR was significantly differences from operation to finished operation（P〈0. 05）. the D/S and S1 / S2 variation were significantly differences after anesthesia （P〈0. 05）. Conclusion The cardiac function were up-regulated after anesthesia in women of cesarean section. The mobilization were observed in HR reserve, cardiac function reserve and diastolic reserve,cardiac function were restore after finished operation. Cardiac accident did not happened. The exercise cardiac contractility monitor may measure cardiac reserve and predict cardiac safety during artificial abortion with general anesthesia.

关 键 词：麻醉 剖宫产 心脏储备 

分 类 号：R713.41[医药卫生—妇产科学]