CAJ | 학술논문

目的：探讨孕期体质量增加对剖宫产手术中产妇心率变异性（HRV ）和低血压的影响。方法选择2011年1月至2013年12月132例产妇为研究对象，按照孕期增加体质量的不同分为3组。A组44例产妇孕期体质量增加小于11 kg ；B组44例产妇孕期体质量增加11～16 kg ；C组44例产妇孕期体质量增加大于16 kg。统计3组术中麻醉、产妇血压、心率、术中低血压率、H RV及新生儿评分情况。结果3组麻醉至分娩时间、术中收缩压、最低血压、心率、盐酸麻黄碱用量、阿托品术中用量，新生儿1 min Apgar评分、新生儿5 min Apgar评分比较，差异均无统计学意义（P＞0．05）。A组HRV各指标均大于B组和C组，差异有统计学意义（P＜0．01）；但B组和C组间比较，差异无统计学意义（ P＞0．05）。A组低血压发生率明显高于B组、C组（χ2＝10．5797，P＝0．0050），但B组、C组间比较，差异无统计学意义（P＞0．05）。结论孕期体质量增加较小的产妇行剖宫产麻醉时 HRV增加，产妇低血压发生率增大，因此术中应密切监测相关指标。
목적：탐토잉기체질량증가대부궁산수술중산부심솔변이성（HRV ）화저혈압적영향。방법선택2011년1월지2013년12월132례산부위연구대상，안조잉기증가체질량적불동분위3조。A조44례산부잉기체질량증가소우11 kg ；B조44례산부잉기체질량증가11～16 kg ；C조44례산부잉기체질량증가대우16 kg。통계3조술중마취、산부혈압、심솔、술중저혈압솔、H RV급신생인평분정황。결과3조마취지분면시간、술중수축압、최저혈압、심솔、염산마황감용량、아탁품술중용량，신생인1 min Apgar평분、신생인5 min Apgar평분비교，차이균무통계학의의（P＞0．05）。A조HRV각지표균대우B조화C조，차이유통계학의의（P＜0．01）；단B조화C조간비교，차이무통계학의의（ P＞0．05）。A조저혈압발생솔명현고우B조、C조（χ2＝10．5797，P＝0．0050），단B조、C조간비교，차이무통계학의의（P＞0．05）。결론잉기체질량증가교소적산부행부궁산마취시 HRV증가，산부저혈압발생솔증대，인차술중응밀절감측상관지표。
Objective To study effect of weight gain during pregnancy on heart rate variability and hypoten‐sion during caesarean section under spinal anaesthesia .Methods A total of 132 pregnant women were selected as the object of study from January 2011 to December 2013 .All the pregnant woman were divided into three groups accord‐ing to the different increment of weight during pregnancy ,with 44 cases in each group .Pregnancy women in the group A with pregnancy weight gain less than 11 kg .Pregnancy women in the group B with weight gain 11‐16 kg .regnancy women in the group C with weight gain more than 16 kg .Statistics of intraoperative anesthesia ,maternal blood pres‐sure ,heart rate and neonatal score ,the rate of hypotension during operation ,HRV and Apgar score were recorded . Results Time from anesthesia to delivery ,the lowest blood pressure ,heart rate ,intraoperative systolic blood pres‐sure ,the dosage of ephedrine hydrochloride and atropine during operation ,1 minutes and 5 minute Apgar score showed no statistical significant difference in the two groups (P>0 .05) .HRV parameters in the group A were high‐er than those of group B and group C ,the difference was statistical significant (P<0 .01) ,but there was no statistical significant difference between group B and group C (P>0 .05) .The incidence of hypotension in group A was higher than that in group B ,group C (χ2 =10 .579 7 ,P=0 .005 0) ,but there was no significant difference between group B and group C (P>0 .05) .Conclusion HRV of women whose weight gain less than 11 kg during pregnancy increases during maternal cesarean section anesthesia ,maternal hypotension risk increases ,so indexes of them should be moni‐tored closely during operation .