Haruta M, Funato T, Sumida T, Naka Y, Saeki N, Shinkai T
Nihon Sanka Fujinka Gakkai Zasshi. 1986 Jun;38(6):909-16.
Intervillous (IV), arterial (MA), and umbilical venous (UV) and arterial (UA) blood-gas values were measured in 36 healthy pregnant women. The patients were divided into three equal groups and underwent elective cesarean sections under spinal block. Oxygen was administered through a nasal cannula (group OL) or a mask (group OH), through group RA received no oxygen inhalation. Mean MAPO2 in each group was 102.0, 213.9 and 482.4 mmHg, respectively. Intervillous PO2 (Mean +/- SD mmHg) was 49.0 +/- 7.1 in group RA, 63.1 +/- 14.5 in group OL, 84.6 +/- 25.2 in group OH, oxygen saturation (%) was 83.2 +/- 6.0, 89.6 +/- 5.5 and 94.3 +/- 2.6, respectively, and oxygen content (CO2: ml/dl) was 12.7 +/- 0.9, 13.7 +/- 1.0 and 14.4 +/- 0.5, severely. There were significant differences in the intervillous oxygen values among the three groups. The intervillous acid-base value in group RA (pH: 7.389 +/- 0.013, PCO2: 33.9 +/- 2.3 mmHg and BD: 4.4 +/- 0.9 m mol/l) showed no significant differences from those of the other groups. Mean UVCO2 was somewhat greater than mean IVCO2 in any group due to the relatively higher oxygen affinity of fetal blood. Both IV and UVPO2 were not so elevated with oxygen inhalation and this was assumed to be due to characteristics of the oxyhemoglobin dissociation curve. The other results produce reliable evidence that placental circulation is not affected by maternal hyperoxia and that an increase in (IV-UA)PO2 facilitates oxygen transfer to the fetus.
对36名健康孕妇测定了绒毛间隙(IV)、母体动脉(MA)、脐静脉(UV)及脐动脉(UA)的血气值。将患者分为三组,每组人数相等,在腰麻下行择期剖宫产术。通过鼻导管给氧(OL组)或面罩给氧(OH组),RA组不吸氧。每组的平均MAPO2分别为102.0、213.9和482.4 mmHg。RA组绒毛间隙PO2(平均值±标准差mmHg)为49.0±7.1,OL组为63.1±14.5,OH组为84.6±25.2,氧饱和度(%)分别为83.2±6.0、89.6±5.5和94.3±2.6,氧含量(CO2:ml/dl)分别为12.7±0.9、13.7±1.0和14.4±0.5,差异有统计学意义。三组间绒毛间隙氧值有显著差异。RA组绒毛间隙酸碱值(pH:7.389±0.013,PCO2:33.9±2.3 mmHg,BD:4.4±0.9 mmol/l)与其他组无显著差异。由于胎儿血对氧的亲和力相对较高,任何一组中脐静脉CO2均值均略高于绒毛间隙CO2均值。吸氧时绒毛间隙和脐静脉PO2升高不明显,推测这是由于氧合血红蛋白解离曲线的特性所致。其他结果提供了可靠证据,表明胎盘循环不受母体高氧影响,且(IV-UA)PO2升高有助于氧向胎儿的转运。