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目的 :探讨脊神经阻滞是否通过调节孕妇的内分泌水平而发挥其作用。方法 :测定重度妊高征患者 (PIH组 ) 2 0例 ,随机分为蛛网膜下腔阻滞组 (SB)和硬膜外腔阻滞 (EB)组 ,各 10例。正常未孕妇女 (NNP组 ) 12例 ,正常晚期妊娠妇女 (NL P组 ) 18例。3组经腰段脊神经阻滞前、后血浆雌激素水平的变化。雌激素的测定采用放免分析法进行测定。数据用 SPSS软件进行 t检验。结果 :NL P组雌激素水平为 (71.6 6± 19.2 2 ) pg/ ml、PIH组 (2 11.12±47.6 1) pg/ m l较 NNP组 (374.16± 12 2 .6 1) pg/ m l明显降低 (P <0 .0 1) ,PIH组较 NL P组明显降低 (P <0 .0 5 ) ,PIH组 SB(2 37± 6 7.2 3) pg/ m l,EB(2 88.5± 6 1.2 6 ) pg/ ml)后均较阻滞前升高 (P <0 .0 5 ) ,且 EB较 SB升高明显(P <0 .0 5 )。结论 :妊高征病人较正常妊娠晚期妇女体内雌激素水平降低 ,而脊神经阻滞可以提高妊高征病人体内雌激素水平。硬膜外阻滞较蛛网膜下腔阻滞使妊高征病人体内雌激素水平升高更明显。
Objective: To investigate whether spinal nerve blockade plays its role by regulating endocrine levels in pregnant women. Methods: Twenty patients with PIH (PIH group) were randomly divided into subarachnoid block group (SB) and epidural block (EB) group, 10 in each. Twelve cases were normal pregnant women (NNP group) and 18 cases were normal pregnant women (NL P group). Changes of plasma estrogen levels in the three groups before and after lumbar spinal block. Estrogen was determined by radioimmunoassay. Data were t-tested using SPSS software. Results: The estrogen level in NL P group was significantly lower than that in NNP group (71.66 ± 19.2 2 pg / ml), PIH group (11.12 ± 47.6 1) pg / ml vs NNP group (374.16 ± 12.2.61 pg / ml) P <0.01), PIH group was significantly lower than NLP group (P <0. 05), PIH group SB (2 37 ± 6 7.2 3) pg / ml, EB / ml) were significantly higher than those before arrest (P <0.05), and the EB was significantly higher than SB (P <0.05). Conclusions: Estrogen levels in women with PIH are lower than those in the normal third trimester of pregnancy, while spinal nerve block can increase estrogen levels in PIH patients. Epidural block compared with subarachnoid block so that patients with pregnancy-induced hypertension increased estrogen levels more pronounced.