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目的 探讨术前禁食输液对选择性剖宫产母婴血糖的影响。方法 2 0 0 2年 11月至 2 0 0 3年 2月将 10 2例行剖宫产的健康产妇分为 3组 ,Ⅰ组 :术前禁食时间 <16h ,未输液体 ;Ⅱ组 (对照组 ) :术前禁食时间≥ 16h(最长2 2h)未输液体 ;Ⅲ组 (输液组 ) :禁食时间≥ 16h术前 2～ 3h静脉输注 5 %葡萄糖复方乳酸钠注射液 5 0 0mL。测定孕妇产时血糖 ,尿常规及新生儿出生后 30min未开奶血糖值 ,并进行比较。结果 Ⅰ组及Ⅲ组孕妇及新生儿血糖值均高于Ⅱ组 ,Ⅱ组母亲及新生儿低血糖发生率分别达到 5 6 7%、33 3% ,明显高于Ⅰ组及Ⅲ组 ,差异有显著性意义 (P <0 0 1)。Ⅱ组母亲产时合并酮症率 6 3 3%高于Ⅰ组及Ⅲ组 ,但差异无显著性意义 (P >0 0 5 )。结论 行剖宫产的产妇 ,术前禁食时间以 <16h为宜。若达到或超过 16h ,术前应静脉输注 5 %葡萄糖液 5 0 0mL(10 g/h) ,可减少母婴低血糖的发生。
Objective To investigate the effect of preoperative fasting transfusion on maternal-fetal glucose in selective cesarean section. Methods From November 2002 to February 2003, 102 healthy pregnant women who underwent cesarean delivery were divided into three groups. Group Ⅰ: preoperative fasting time <16 hours, no fluid infusion; group Ⅱ ( (Control group): preoperative fasting time ≥ 16h (up to 2h) did not lose the liquid; Ⅲ group (infusion group): fasting time ≥ 16h 2 ~ 3h preoperative intravenous infusion of 5% glucose compound sodium lactate 50 0mL. Determination of pregnant women during birth blood sugar, urine and newborn after birth 30min unincorporated blood glucose values, and compared. Results The blood glucose of pregnant women and newborn in group Ⅰ and group Ⅲ were higher than those in group Ⅱ. The incidence of hypoglycemia in mothers and newborns in group Ⅱ was 56.7% and 33.3% respectively, which was significantly higher than that in groups Ⅰ and Ⅲ Significant significance (P <0.01). In group Ⅱ, the incidence of ketogenesis during delivery was 63.3% higher than that of group Ⅰ and Ⅲ, but the difference was not statistically significant (P> 0.05). Conclusion Cesarean section of maternal, preoperative fasting time <16h is appropriate. If reached or exceeded 16h, preoperative intravenous infusion of 5% glucose solution 500mL (10g / h), can reduce the incidence of maternal and hypoglycemia.