远程肢体缺血预处理在择期剖宫产手术中的应用  

The application of remote limb ischemic preconditioning in elective cesarean section

作　　者：郑官林 郑晓春[2] 

机构地区：[1]福建省妇幼保健院麻醉科,福州350001 [2]福建省立医院麻醉科,福州350001

出　　处：《中国当代医药》2014年第6期115-116,119,共3页China Modern Medicine

基　　金：福建省自然科学基金(2013J01116)

摘　　要：目的探讨远程肢体缺血预处理应用在择期剖宫产手术中的可行性。方法选择本院拟择期行剖宫产手术的足月产妇40例,随机分为两组(n=20),A组于择期剖宫产前进行常规术前检查与准备;B组在择期剖宫产前除完成常规的术前检查与准备外,并于剖宫产前2 h进行左下肢缺血预处理。两组产妇均于胎儿娩出后采集脐动脉血测定MDA、SOD含量,对比胎儿娩出时两组产妇MBP、HR的波动情况、脐动脉血中MDA、SOD含量比较,以及新生儿的Apgar评分。结果与A组比较,B组产妇在胎儿娩出时MBP、HR更为稳定,两组间比较,差异有统计学意义(P<0.05);而采集的脐动脉血中MDA含量A组高于B组,而SOD含量B组显著高于A组,两组间比较,差异均有统计学意义(P<0.05);在新生儿Apgar评分中,A组低于B组(P<0.05)。结论肢体缺血预处理能安全有效地应用于择期剖宫产手术中。Objective To explore the feasibility of application of remote limb ischemic preconditioning in elective cesarean section. Methods 40 cases of parturient who will electively accept caesarean section were randomly divided into two groups（n=20）,in the group A,the routine preoperative examination and preparation was done prior to the elective cesarean section;in the group B,in addition to completion the routine preoperative examination and preparation before elective cesarean,the left lower limb ischemic preconditioning was given 2 hours before the cesarean section.After fetus was delivered,the umbilical artery blood was collected from the two groups of parturient and determined the MDA,SOD content.The MBP,HR fluctuation of two groups and the MDA,SOD content in umbilical artery were compared as well as the neonatal Apgar score. Results Compared with group A,the MBP,HR of parturient in group B was more stable when delivered fetus,with statistical significance（P0.05）; while in the collected umbilical artery blood,the MDA content of group A was higher than that of group B,whereas the content of SOD in group B was significantly higher than that of group A.The differences between two groups were all statistically significant（P0.05）;the neonatal Apgar score of group A was lower than that of group B,with significant difference（P0.05）. Conclusion The remote limb ischemic preconditioning can safely and effectively applied in elective cesarean section.

关 键 词：远程肢体缺血预处理 剖宫产 手术 

分 类 号：R473.71[医药卫生—护理学]