论文部分内容阅读
目的探讨胎羊间断性脐带闭塞后的血流动力学特点及与脐动脉血气变化的关系。方法12只晚孕山羊于妊娠116~130d行宫内外科手术,用套囊充气闭合器完全夹闭脐带,每次钳夹90s,间隔30min,重复5次。于第一次钳夹前5min、每次钳夹后3min均应用彩色多普勒血流显像技术检测血流参数,抽取胎羊脐动脉血做血气分析。结果实验组钳夹后脐动脉搏动指数(PI)、肾动脉(RA)、静脉导管PI、左心室Tei指数、右心室Tei指数均升高(P<0.05),并且高于对照组(P<0.05);动脉血酸碱度(pH)、动脉血氧分压(PaO2)下降(P<0.05),动脉血二氧化碳分压(PaCO2)升高(P<0.05),与对照组比较差异有统计学意义(P<0.01)。实验组脐动脉PI、肾动脉PI、静脉导管PI、右心室Tei指数、左心室Tei指数与血pH呈负相关(r=-0.431,r=-0.506,r=-0.358,r=-0.538,r=-0.681,P<0.01),与血PaO2呈负相关(r=-0.446,r=-0.478,r=-0.435,r=-0.684,r=-0.725,P<0.01),与血PaCO2呈正相关(r=0.410,r=0.524,r=0.699,r=0.682,r=0.780,P<0.01)。结论晚孕期脐带间断闭塞可导致胎羊宫内缺氧及多项血流动力学指标变化,静脉导管PI和Tei指数与血气指标的相关性好。因此,静脉导管PI和Tei指数可能成为预测胎儿宫内缺氧简便而有效的指标。
Objective To investigate the hemodynamic characteristics of fetal umbilical cord interrupted umbilical cord occlusion and its relationship with changes of umbilical artery blood gas. Methods Twelve pregnant goats underwent intrauterine and uterine surgery during 116 ~ 130 days of gestation. The umbilical cord was completely closed with a cuff inflatable closure device. The jaws were clamped for 90 seconds at intervals of 30 minutes and repeated 5 times. Blood flow parameters were measured by color Doppler flow imaging at 5 min before the first clamp and 3 min after each clamp. Blood was drawn from the umbilical artery of the fetus. Results The umbilical artery pulsatility index (PI), renal artery (RA), venous catheter PI, Tei index of left ventricle and Tei index of right ventricle in experimental group were significantly higher than those in control group (P < 0.05). The arterial blood pH, PaO2 and PaCO2 increased (P <0.05), and the difference was statistically significant compared with the control group (P <0.01). In the experimental group, the umbilical artery PI, the renal artery PI, the venous catheter PI, the Tei index of the right ventricle and the Tei index of the left ventricle were negatively correlated with the blood pH (r = -0.431, r = -0.506, r = -0.358, r = -0.538, (r = -0.681, P <0.01) and negatively correlated with PaO2 (r = -0.446, r = -0.478, r = -0.435, r = -0.684, r = -0.725, P <0.01) (R = 0.410, r = 0.524, r = 0.699, r = 0.682, r = 0.780, P <0.01). Conclusion Intermittent umbilical cord occlusion during late pregnancy leads to intrauterine hypoxia and many hemodynamic parameters in sheep fetus. The correlation between PI and Tei index of venous catheters and blood gas indexes is good. Therefore, the PI and Tei index of venous catheters may be a simple and effective indicator for predicting fetal hypoxia.