潘贤 潘宁玲 王红 肖英 100700 北京军区总医院麻醉科(潘贤、潘宁玲)，本院超声科(王红)，本院妇产科(肖英) 中华麻醉学杂志 1999 0 19 6


    关键词：剖宫产术；麻醉，硬膜外；局部血流；脐动脉；脐静脉 期刊 zhmzxzz 0 临床研究 fur -->/info/meeting/meeting02.asp?keyword=麻醉学


    

【摘要】 目的 观察剖宫产术硬膜外阻滞时对胎儿脐血流的影响。方法 采用多普勒超声仪，探头频率3.5MHz。麻醉前测脐静脉(U_V )、脐动脉(U_A )直径。记录U_A 收缩期峰值速度(Vmax)、舒张期最低速度(Vmin)、平均速度(Vmean)。算出Vmax及Vmin之比(S/D)、搏动指数(PI)及阻力指数(RI)。脉冲多普勒取样线与脐动脉长轴夹角θ≤20度。产妇硬膜外穿刺取左侧卧位，于L_2～3 穿刺成功后硬膜外腔注入1.33%利多卡因及0.17%丁卡因混合液20ml后向头侧置管；待麻醉平面达T_8～9 后(约10分钟)再监测上述各项参数。结果 麻醉后U_V 及U_A 血流量明显高于麻醉前(P<0.05)。S/D、PI及RI麻醉前后无明显变化(P>0.05)。结论 硬膜外阻滞后可增加脐血流而不增加脐血管阻力，对胎儿血供是有利的。

Effect of umbilical blood flow during cesarean section under epidurial anesthesia

PAN Xianbi, PAN Ningling, WANG Hong, et al.

Department of Anesthesia, General Hospital of Beijing Military District, Beijing 100700

【 Abstract】 Objective To determine the effect of epidural anesthesia on the umbilical blood flow during cesarean section. Methods Eighteen patients received 20 ml mixed solution of 1.33% lidocaine and 0.17%dicaine epidurally in the left lateral position.The diameters of umbilical vein(Uv)and umbilicalartery(Ua), maximum systolic velocity(Vmax),diastolic minimum velocity(Vmin) , meanvelocity(Vmean) ,ratio of Vmax to Vmin(S/D), pulsatility index(PI),and resistance index(RI) were measured with the technique of colour Doppler ,before anesthesia and 10 min following anesthesia.Results Uv and Ua increased significantly during anesthesia compared with those before anesthesia (P<0.05), and there were not significant changes in S/D,PI,and RI(P>0.05).Conclusion Epidural anesthesia increase umbilical blood flow ......

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