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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 |
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孙岩军 赵钢 周本瑜
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0.21）、A2（小于0.21）和B1（大于0.21）、B2（小于0.21）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0.16～0.25。HOU／BH大于0.21，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0.21的剖宫产患者，应适当掌握麻醉平面，以免影响其通气功能。
关键词 妊娠 阻滞平面 通气功能
Predicting the Effect of Anesthetic Plane on Respiration Function Using a Ratio of Height of the Uterus to body Height of Pregnant Women
Sun Yanjun，Zhao Gang，Zhou Benyu
(Department of Ansthesiology，the Affiliated Hospital of Nanjing Railway Medical College，Nanjing 210009)
Abstract 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 VT，RR， SpO2 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 T6，VT will be decreased，RR increased and SpO2 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 T6 to avoid respiratory depression in the pregnant woman with a ratio of HOU／BH greater than 0.21．
Key words Pregnancy Anesthetic plane Ventilation function
硬膜外麻醉用于剖宫产时，麻醉平面可影响患者的呼吸功能。此外，妊娠妇女增大的子宫限制膈肌的运动。仅以子宫大小来衡量其对呼吸的影响程度显然有失偏颇，且无统一标准。为此，我们测量了宫高／身高（HOU／BH）比值，并评价了HOU／BH与硬膜外阻滞平面影响呼吸功能的相互关系。
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