羊膜腔输液时羊水渗透浓度变化的实验研究

目的: 探讨因胎儿窘迫进行羊膜腔输液时羊水渗透浓度变化, 为其临床应用提供客观依据。方法: 随机选择30例正常产妇作正常组, 70例胎儿窘迫者作为胎儿窘迫组, 其中 40例行羊膜腔输液作治疗组, 30例接受传统的宫内复苏治疗为对照组。取各组羊水进行渗透浓度测定分析; 每例新生儿出生时行Apgar1min及 5min评分。结果: 胎儿窘迫组的羊水渗透浓度 (223. 00±10. 60mmol/L) 较正常组 (261. 73 ±14. 16mmol/L) 显著降低 (P<0 .005 ); 治疗组行羊膜腔输液后的羊水渗透浓度显著升高 (271 ±13 46mmol/L), 与正常组无显著性差异 (P>0 .05); 治疗组的新生儿窒息率、因胎儿窘迫而行剖宫产率 (分别为 5 0%、2 5% ) 较对照组 (分别为 16 7%、13 3% ) 显著降低 (P<0. 05, P<0. 05), 而与正常组 (分别为 3 3%、6 7% ) 相比无显著性差异 (P>0. 05, P>0 .05)。结论: 羊膜腔输液不仅可补充适量羊水来缓解因羊水过少使胎儿受压而导致缺氧, 还可通过羊水渗透浓度的变化来改善胎儿宫内状况, 是一种治疗胎儿窘迫的适宜技术。

Changes in Osmotic Consentration of Amnionic Fluid During Amnioinfusion

Objective:By quantifying the changes in osmotic concentration of amnionic fluid during amnioinfusion for fetal distress to provide objective basis for clinical application.Methods:30 cases of natural puerperas were selected randomly as normal group; 70 cases of pueperas with fetal distress as fetal distress group, which were divided randomly into treatment group (40 cases received amnioinfusion) and control group (30 cases treated with the traditional three drug combination treatment). In every case, amnionic fluid was drawn to measure its osmotic concentration. All babies had been done Apgar-score on delivery for 1 ~ 5 minutes.Results:The osmotic concentration (223.00±10.60 mmol/L) in fetal distress group significantly decreased than that in normal group (261.73±14.16 mmol/L) (P<0.005), the osmotic concentration in treatment group (271±13.46 mmol/L) significantly increased comparing to normal group (P>0.05).The neonatal asphyxia and rate of cesarean sections for fetal distress in treatment group significantly decreased (5.0%, 2.5% vs 16.7%, 13.3%) comparing to those in control group (P<0.05,P<0.05), but there was no significant difference comparing to that (3.3%, 6.7%) in normal group (P>0.05,P>0.05).Conclusion:Amnioinfusion not only can relief hypoxia resulting from oligohydramnios, but also can improve the intrauterine status through the changes of osmotic concentration of amnionic fluid.