Lu H, Chiang Y Y, Lin Z C, Chou C D, Hong P Y, Cheng R Y, Leung H K
Department of Anesthesia, Taipei Municipal Yang-Ming Hospital, Taiwan, R.O.C.
Ma Zui Xue Za Zhi. 1991 Dec;29(4):709-14.
The purpose of the study is to probe the situation of venous air embolism (VAE) and the accompanying complications occurring in Chinese parturients in Taiwan during Cesarean section. Sixty ASA physical status class I-II parturients who were subjected to cesarean section under regional anesthesia were evaluated. The sensor of the Doppler device was placed on the anterior chest to detect the rumbles of air when it came to pass, and simultaneously the signs and symptoms following VAE were observed. Our results demonstrated that the usual or normal Doppler heart sound changed in 38 parturients out of 60 (63.3%), and the alteration occurred very often when the uterus was being incised (81.6%), or sutured (97.4%), and concurred strong correlation with such signs and symptoms such as chest tightness or precordial pain (78.9%), shortness of breath (60.5%), and change of heart rate or blood pressure (86.8%). The method of anesthesia (spinal or epidural block) did not have effect on the occurrence of VAE, but different surgical approaches and different positions in which the patients were posed during operation did apparently bring about VAE of variable degree. Besides, supplying of oxygen could mitigate the symptoms produced by VAE. Consequently, the application of Doppler monitor during Cesarean section can detect VAE earlier and more efficiently and thus provides information timely treatment.
本研究旨在探讨台湾地区中国产妇剖宫产时静脉空气栓塞（VAE）及伴随并发症的发生情况。对60例接受区域麻醉下行剖宫产的ASA身体状况I-II级产妇进行评估。将多普勒装置的传感器置于前胸，以检测空气通过时的隆隆声，同时观察VAE后的体征和症状。我们的结果表明，60例产妇中有38例（63.3%）正常或常规的多普勒心音发生改变，这种改变在子宫切开时（81.6%）或缝合时（97.4%）经常出现，并且与胸闷或心前区疼痛（78.9%）、呼吸急促（60.5%）以及心率或血压变化（86.8%）等体征和症状密切相关。麻醉方法（腰麻或硬膜外阻滞）对VAE的发生没有影响，但不同的手术方式以及手术过程中患者的不同体位显然会导致不同程度的VAE。此外，吸氧可减轻VAE产生的症状。因此，剖宫产时应用多普勒监测可更早、更有效地检测VAE，从而为及时治疗提供信息。
