应用宫高/身高比值预测麻醉平面对剖宫产患者呼吸的影响  

Predicting the Effect of Anesthetic Plane on Respiration Function Using a Ratio of Height of the Uterus to body Height of Pregnant Women

作　　者：孙岩军[1] 赵钢[1] 周本瑜[1] 

机构地区：[1]南京铁道医学院附属医院麻醉科,210009

出　　处：《临床麻醉学杂志》2000年第11期542-543,共2页Journal of Clinical Anesthesiology

摘　　要：目的 :测定健康足月妊娠妇女宫高 /身高 (HOU/BH)正常值范围 ,并在此范围内探讨HOU/BH于不同麻醉平面下对患者呼吸功能的影响。方法 :患者在不同阻滞平面下 ,按HOU/BH值分A1(大于 0 2 1)、A2 (小于 0 2 1)和B1(大于 0 2 1)、B2 (小于 0 2 1)四个亚组 ,其中A1、A2为高平面组 ,B1、B2为低平面组。各组分别于麻醉前、胎儿娩出前、娩出后 30分钟记录VT、RR、SpO2 。结果 :健康足月妊娠妇女HOU/BH正常值范围 0 16～ 0 2 5。HOU/BH大于0 2 1,麻醉平面高于T6时VT 将减少 ,RR增加 ,SpO2 降低 ,患者常诉有呼吸困难。结论 :HOU/BH大于 0 2 1的剖宫产患者 ,应适当掌握麻醉平面 。Objective:Employing the ratio of height of the uterus (HOU) to body height(BH)to predict the effect of anesthetic plane on respiration function in the pregnant.Methods:After getting the normal value scope of HOU/BH,all patients were allocated into A1(HOU/BH greater than 0 21),A2(HOU/BH less than 0 21),B1(HOU/BH greater than 0 21)and B2(HOU/BH less than 0 21)groups,in which A1,A2 at high anesthetic level and B1,B2 at low anesthetic level.Their V T,RR, SpO 2 were recorded.Results:Based on this group the normal scope of HOU/BH of a healthy mature pregnant woman is 0 16 0 25.Within this scope,if HOU/BH is greater than 0 21 and anesthetic plane over T 6,V T will be decreased,RR increased and SpO 2 lowered.Conclusion:It is necessary for the caesarian operation patient whose HOU/BH is over 0 21 to keep informed on anesthetic level in case of the influence of the ventilation function for the anesthetic plane should be kept less than T 6 to avoid respiratory depression in the pregnant woman with a ratio of HOU/BH greater than 0 21.

关 键 词：通气功能 剖宫产 宫高/耳高 硬膜外麻醉平面 

分 类 号：R719.8[医药卫生—妇产科学] R614.42[医药卫生—临床医学]