腰麻剖宫产低血压不同防治措施下胎盘的体视学研究

摘要：目的探讨一种有效防治剖宫产低血压且对母婴最有利的方法。方法选择单胎足月择期行腰麻下剖宫产的初产妇
40例，随机分为两组，分别给予静脉预注麻黄素和术前预充万汶防治腰麻后低血压。记录术中心率（HR）、收缩压（SBP）、
舒张压（DBP）、1 min及5 min的Apgar评分。抽取脐动脉血进行血气分析。同时，取胎盘组织进行常规免疫组织化学染
色，通过抗CD34标记血管内皮细胞显示血管的方法，进行胎盘绒毛间质内微血管体视学研究。结果麻黄素组心率，低血
压发生率和脐动脉血乳酸值明显高于万汶组，差异有统计学意义(P<0.05)，麻黄素组脐动脉血pH值明显低于万汶组，差异
有统计学意义(P<0.05)。两组微血管长度密度差异无统计学意义(P>0.05)，麻黄素组微血管体积密度明显小于万汶组，差
异有统计学意义(P<0.05)。结论剖宫产腰麻前应用万汶预扩容能增加母体有效循环血容量，维持母体循环稳定。通过体
视学分析，扩容有利于增加子宫胎盘血量，从而改善胎儿血供和氧供。

Stereological study of the placenta in parturients with different prophylactic measures for hypotension during spinal anesthesia for cesarean section

Objective To explore the optimal approach to the prevention of hypotension during cesarean section for the benefits of both the parturients and the newborns.Methods Forty singleton full-term pregnant women undergoing elective cesarean delivery were randomly allocated into two equal groups.For prevention of hypotension during spinal anesthesia,ephedrine or pre-anesthetic volume with Voluven was administered.The changes of blood pressure,heart rate,and Apgar scores of the newborns were monitored and recorded,...