CAJ | 학술논문

目的：观察剖宫产术前应用醋酸钠钾镁钙葡萄糖注射液对新生儿血气、血糖、乳酸及电解质的影响。方法选取2013年5月至12月需行剖宫产手术患者60例，依据分层随机分组法将患者分为治疗组及对照组，每组30例。对照组给予常规术前准备并进行剖宫产术；治疗组在对照组处理的基础上于术前加用醋酸钠钾镁钙葡萄糖注射液进行治疗。观察比较两组孕产妇手术前后血糖、游离脂肪酸、酮体变化以及用药不良反应情况，检测两组新生儿血气分析、电解质、血糖、乳酸及Apgar评分情况。结果术前两组孕产妇空腹血糖（FBG）、游离脂肪酸（NEFA）及酮体（KB）比较，差异无统计学意义（ P>0.05）。术后治疗组孕产妇FBG为（6.75±1.71）mmol/L，明显高于对照组的（5.86±1.62）mmol/L，孕产妇 NEFA 为（0.57±0.18）mmol/L，KB 为（0.14±0.06）mmol/L，均分别低于对照组的（0.71±0.26）mmol/L和（0.19±0.09）mmol/L（ P<0.05）；治疗组新生儿动脉血二氧化碳分压（PaCO2）、HCO3－及乳酸水平明显低于对照组，血氧分压（PaO2），pH，Ca2+，Mg2+，新生儿血糖（NBG）及Apgar评分均明显高于对照组（ P<0.05）。术后两组孕产妇心电图ST段降低，心律不齐、肺水肿及末梢水肿等药品不良反应发生率差异无统计学意义（ P>0.05）。结论剖宫产术前应用醋酸钠钾镁钙葡萄糖注射液，可显著改善孕产妇能量物质代谢情况及新生儿血气、电解质状况，并可提高新生儿Apgar评分。
목적：관찰부궁산술전응용작산납갑미개포도당주사액대신생인혈기、혈당、유산급전해질적영향。방법선취2013년5월지12월수행부궁산수술환자60례，의거분층수궤분조법장환자분위치료조급대조조，매조30례。대조조급여상규술전준비병진행부궁산술；치료조재대조조처리적기출상우술전가용작산납갑미개포도당주사액진행치료。관찰비교량조잉산부수술전후혈당、유리지방산、동체변화이급용약불량반응정황，검측량조신생인혈기분석、전해질、혈당、유산급Apgar평분정황。결과술전량조잉산부공복혈당（FBG）、유리지방산（NEFA）급동체（KB）비교，차이무통계학의의（ P>0.05）。술후치료조잉산부FBG위（6.75±1.71）mmol/L，명현고우대조조적（5.86±1.62）mmol/L，잉산부 NEFA 위（0.57±0.18）mmol/L，KB 위（0.14±0.06）mmol/L，균분별저우대조조적（0.71±0.26）mmol/L화（0.19±0.09）mmol/L（ P<0.05）；치료조신생인동맥혈이양화탄분압（PaCO2）、HCO3－급유산수평명현저우대조조，혈양분압（PaO2），pH，Ca2+，Mg2+，신생인혈당（NBG）급Apgar평분균명현고우대조조（ P<0.05）。술후량조잉산부심전도ST단강저，심률불제、폐수종급말소수종등약품불량반응발생솔차이무통계학의의（ P>0.05）。결론부궁산술전응용작산납갑미개포도당주사액，가현저개선잉산부능량물질대사정황급신생인혈기、전해질상황，병가제고신생인Apgar평분。
Objective To observe the effect of Sodium Acetate Potassium Magnesium Calcium Glucose Injection on neonatal blood gas, blood glucose, lactate and electrolytes before cesarean section. Methods 60 pregnant woman requiring cesarean section in our hospital from May to December 2013 were divided into the treatment group and the control group according to the stratified randomized method, 30 cases in each group. The control group was given the routine preoperative preparation and performed cesarean section;while the treatment group was added with Sodium Acetate Potassium Magnesium Calcium Glucose Injection before operation on the basis of the control group treatment;the changes of blood glucose, free fatty acids, ketone bodies ( KB ) and adverse drug reactions before and after operation were observed and compared between the two groups; the blood gas analysis, electrolytes, blood glucose, lactate and Apgar scores of neonates after cesarean section were detected in the two groups. Results The fasting blood glucose ( FBG ) , free fatty acid ( NEFA ) and KB before operation had no statistical differences between the two groups ( P>0. 05 ); FBG after operation was ( 6. 75 ± 1. 71 ) mmol/L in the treatment group, which was higher than ( 5. 86 ± 1. 62 ) mmol/L in the control group, NEFA and KB were ( 0. 57 ± 0. 18 ) mmol/L and ( 0. 14 ± 0. 06 ) mmol/L in the treatment group, which were lower than ( 0. 71 ± 0. 26 ) mmol/L and ( 0. 19 ± 0. 09 ) mmol/L in the control group, the differences were statistically significant ( P< 0. 05 ); the arterial carbon dioxide partial pressure ( PaCO2 ) , HCO3 - and lactate levels in the neonates of the treatment group were significantly lower than those in the control group, while the arterial oxygen tension ( PaO2 ) , pH value, Ca2 +, Mg2+, neonatal blood glucose ( NBG ) and Apgar scores were significantly higher than those in the control group, the differences were statistically significant ( P<0. 05 );The adverse drug reactions of ECG ST segment de-pression, arrhythmias, pulmonary edema and peripheral edema had no statistical differences between the two groups ( P > 0. 05 ) . Conclusion Using Sodium Acetate Potassium Magnesium Calcium Glucose Injection before cesarean section can significantly improve the energy substance metabolism in pregnant and lying-in woman and the condition of neonatal blood gas and electrolytes , and can improve the Apgar scores of neonates.