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为观察不同类型心脏病患者连硬麻醉剖宫产术中循环功能变化,提高母婴生命安全,采用超声多普勒连续测定术中血流动力学变化。62例心脏病患者,分为1.后天性心脏病(Ⅰ组,n=24);2.先心左→右分流(Ⅱ组,n=21);3.先心右一→分流(Ⅲ组,n=17)。按心功能分为1.心功能Ⅰ～Ⅱ级(A 组,n=30);2.心功能Ⅲ～Ⅳ级(B 组,n=32)。结果表明:1.三组心脏病患者连硬麻醉后心脏指数(CI)、外周血管阻力(SVR)均明显下降,其中Ⅲ组最为明显,新生儿气管插管发生率Ⅲ组(37%)、Ⅰ组(34.5%)均明显高于Ⅱ组(28.5%,P<0.05)。2.心功能 B 组 CI、平均动脉压(MAP)、SVR 下降幅度均明显大于 A 组。新生儿气管插管发生率 B 组(79%)明显高于 A 组(21%,P<0.05)。
In order to observe the changes of circulatory function in patients with different types of heart disease during hard anesthesia with cesarean section and to improve the safety of mother and infant, continuous intraoperative hemodynamic changes were measured by Doppler ultrasound. Sixty-two patients with heart disease were divided into two groups: 1. Acquired heart disease (group Ⅰ, n = 24); 2. Left to right shunt (group Ⅱ, n = 21); 3. Right heart → shunt Group, n = 17). According to the cardiac function, the patients were divided into 1 group: heart function Ⅰ ~ Ⅱ (group A, n = 30), heart function Ⅲ ~ Ⅳ (group B, n = 32). The results showed that: (1) The cardiac index (CI) and the peripheral vascular resistance (SVR) of three groups of patients with heart disease decreased significantly after hard anesthesia, the most obvious was in group Ⅲ, the incidence of tracheal intubation in group Ⅲ was 37% Group Ⅰ (34.5%) were significantly higher than those in group Ⅱ (28.5%, P <0.05). Cardiac function B group CI, mean arterial pressure (MAP), SVR decreased significantly more than A group. The incidence of endotracheal intubation in group B (79%) was significantly higher than that in group A (21%, P <0.05).