目的 探讨全身麻醉对剖宫产母亲产时血糖及新生儿血糖的影响.方法 全身麻醉下行剖官产的初产孕妇20例(全麻组)及同期腰硬联合麻醉下行剖宫产年龄、体重相近的足月孕妇20例(腰麻组).全麻组采用丙泊酚100 mg+瑞芬太尼100 μg+琥珀胆碱100 mg;腰麻组采用蛛网膜下腔匀速推注0,5%盐酸罗哌卡因注射液(商品名:耐乐品)2.5～2.6ml.分别于麻醉前、胎儿娩出后即刻测母亲指尖血糖,新生儿出生后10分钟足跟血血糖,同时记录孕妇围术期血压、心率和新生儿Apgar评分.结果 全麻组产妇分娩时血糖水平降低(P<0.05);腰麻组分娩时血糖升高(P<0.05);全麻组新生儿生后血糖明显低于腰麻组(P<0.01);新生儿生后血糖与产妇产时血糖呈显著正相关( r =0.73,P<0.01).结论 全身麻醉产妇分娩时血糖水平降低,新生儿生后血糖明显低于腰硬联合麻醉产妇,应该关注和预防新生儿低血糖的发生.%Objective To observe the effect of general anesthesia on mother and newborn blood glucose levels. Methods 15 patients scheduled for cesarean section under general anesthesia (group Q) and 15 under combined spinal epidural anesthesia (group Y) were involved the study. Patients in group Q were anaesthetized by using 100 mg of propofol, 100μg of remifentanil and 100 mg of scolin while group Y by using 2. 5-2. 6 ml of 0. 5% ropivocayin through spinal injection. The maternal capillary whole blood glucose was recorded before anesthesia and just after delivery. Newborn heel blood glucose was measured at 10 minutes after delivery. At the same time maternal HR and BP were also recorded before and after delivery. The Apgar score of newborn were evaluated as well. Results Maternal capillary whole blood glucose in group Q was significantly lower than that in group Y (P < 0. 01) just after delivery. Blood glucose of newborns in group Q were significantly lower than that in group Y (P < 0. 01) . The blood glucose of newborn was linearly proportional to that of pregnant women (r = 0. 86,P < 0. 01) . Conclusions The blood glucose levels of pregnant women decreased during cesarean section under general anesthesia. The blood glucose levels of their newborns were also lower than that whose mothers under spinal epidural anesthesia. Therefore, it is necessary to take precautions against hypoglycemia of the newborns.
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