腰麻-硬膜外联合阻滞分娩镇痛对妊高征产妇血浆TXA2和PGI2影响的研究

目的 探讨腰麻-硬膜外联合阻滞（CSEA）分娩镇痛对妊娠期高血压综合征（PIH）产妇血浆血栓素A2（TXA2）和前列环素（PGI2）浓度的影响。方法轻、中度PIH产妇50例，随机分为2组，CSEA组30例实施CSEA分娩镇痛，正常分娩组20例未接受任何分娩镇痛药物。2组分别于宫口开至2～3cm时（阻滞前，R）、阻滞后30min（T1）、宫口开全（T2）、胎儿娩出后2h（T3）时抽取患者静脉血样，采用放射免疫法测定血浆TXA，和PGI2的浓度，同时测定产妇的血压，计算平均动脉压（MAP）。结果TXA，浓度和MAPCSEA组低于正常分娩组（P〈0．01）；与Tn比较，CSEA组PGI2浓度在T1时升高（P〈0．05），TXA2浓度无变化，MAP在T1、T2、T3时降低（P〈0．05）；正常分娩组TXA2浓度在T2、T3时升高（P〈0．05），PGI2浓度在T2时降低（P〈0．05），MAP在T1、T2、T3时升高（P〈0．05）。结论对PIH产妇实施CSEA分娩镇痛可降低产妇血压，稳定其血流动力学，减少子痫及胎死宫内的发生，增加产妇分娩的安全度；其机制可能是升高PGI2浓度与阻止TXA2浓度的升高相互作用的结果。

Effects of labor analgesia by combined spinal and epidural anesthesia on the concentrations of TXA2 and PGI2 in plasma in parturients with pregnancy induced hypertension syndrome

Objective To investigate the effects of labor analgesia by combined spinal and epidural anesthesia(CSEA) on blood pressure(BP) and plasma concentrations of thromboxane A2(TXA2) and prostacyclin(PGI2)in parturients with pregnancy induced hypertension syndrome(PIH).Methods 50 parturients with mild or moderate PIH were randomly divided into two groups.The patients in CSEA group(Group 1,n= 30) were performed with labor analgesia by CSEA,however,the parturients in control group(Group 2,n=20) were not administere...