高氧吸入对剖宫产母婴-异前列腺素Fα含量的影响.docVIP

高氧吸入对剖宫产母婴8-异前列腺素 F2α250012 王焕亮 【摘要】目的 探讨高浓度氧气吸入对剖宫产母婴8-F2α含量及新生儿的影响。min、胎儿娩出时分别抽取母动脉血和脐动静脉血测定血气和血浆8-异前列腺素F2α、丙二醛（MDA），同时进行新生儿Apgar评分和NBNA评分。结果 O组病人吸氧10min、胎儿娩出时母动脉血PO2和脐动静脉血PO2显著升高于A组（P 0.05～0.001），血浆8-异前列腺素F2α、MDA浓度亦显著高于A组（P 0.05～0.001）。两组新生儿Apgar评分和NBNA评分无显著性差别，但新生儿第5天NBNA评分行为能力和主动肌张力两项评分均显著高于同组新生儿第1天的评分。结论 短时间高氧吸入使剖宫产母婴脂质过氧化产物8-异前列腺素F2α浓度显著增加，但对新生儿行为神经评分未产生显著影响。 【关键词】剖宫产；高氧；8-异前列腺素F2α，新生儿行为神经学测定 【Abstractive】: Objective To investigate the effect of high inspired oxygen on the concentration of maternal and fetal 8-isoprostane F 2α,the neonate apgar score and the neonatal behavioral neurological assessment (NBNA) in parturients having caesarean section under spinal anaesthesia. Methods Forty-four healthy parturients were randomized to breathe either 21% (air group) or 60% oxygen (oxygen group) intraoperatively via a ventimask. Maternal arterial blood was collected before and 10 min after treatment, delivery, and umbilical arterial and venous blood was collected at delivery. We measured blood gases and the products of lipid peroxidation as 8-isoprostane F 2α and malondialdehyde (MDA). Results The oxygen group had greater maternal arterial PO2 compared with the air group at 10 min after treatment or at delivery (P0.05～0.001), as well as the maternal and umbilical plasma concentrations of 8-isoprostane F 2α and MDA (P0.05～0.001). There were no different between the Apgar score and the NBNA score. Conclusions Breathing high inspired oxygen could increase the concentration of lipid peroxidation, but didn’t cause a concomitant decrease in NBNA scroe. 【Keywords】 caesarean section； hyperoxygen；8-isoprostane F 2α 妊娠晚期呼吸生理的变化以及蛛网膜下腔麻醉（腰麻）对产妇呼吸循环功能的影响，使得腰麻剖宫产病人低氧血症的发生率显著增加。因此，吸氧已成为腰麻剖宫产的一种常规操作。然而研究显示，吸入气氧浓度（FiO2）低于35%时并不能提高脐静脉血氧分压（PO2）[1]。因此，有人提出吸入高氧（FiO250%）以防止产妇低氧血症和胎儿宫内窘迫的发生。但是，高氧吸入可引起体内氧自由基活性增强，是否会对新生儿生长发育造成不利影响尚不明确。本研究通过测定血浆8-异前列腺素F2α含量及新生儿行为神经学评分（the neonatal behavioral neurological assessment，NBNA），观察短时间高氧吸入对腰麻剖宫产母婴自由基活性和新生儿神经发育的影响。 资料与方法 病人资料：根据文献[2]，选择44例美