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分娩期间经皮二氧化碳分压(tcPco2)的临床经验。

Clinical experience on tcPco2 during labor.

作者信息

Schmidt S

机构信息

Institute for Perinatal Medicine, Free University of Berlin, West Germany.

出版信息

J Perinat Med. 1987;15(4):395-401. doi: 10.1515/jpme.1987.15.4.395.

Abstract

tcPco2 measurements in the fetus during labor were evaluated by analysing the clinical experience in 224 cases. This additional mode of supervision was performed in combination with continuous cardiotocography (CTG) and intermittent fetal blood sampling (FBA) in cases with suspect, prepathologic or pathologic heart rate patterns. The prechosen measuring temperature was 39 degrees C in 105 and 44 degrees C in 119 cases. The normal range of the tcPco2 was defined by calculating the mean value and two standard deviations in cases without hypoxic complications. The absolute values of the normal range were different according to the measuring temperature, when no correction factor was used. After adjusting the transcutaneous values to the blood gas level by means of the Severinghaus formular no significant differences in the tcPco2 values were notified for the two applied temperatures (39 degrees C and 44 degrees C). There is an obvious rise of tcPco2 with the progress of labor. Comparing the tcPco2 values with the pH values in the fetal blood we found a statistically significant correlation at either temperatures (p less than 0.001). Aiming at an early detection of raising acidity in the fetal blood, an action line of 55 mmHg after correction (80 mmHg at 44 degrees C, 63 mmHg at 39 degrees C) is an adequate basis for clinical intervention as all acidotic (pH less than 7.20) and the majority of preacidotic value (pH 7.20-7.24) can be excluded. One clinical benefit that can be expected by the additional use of tcPco2 is the reduction in the necessity of fetal blood sampling in a number of cases with abnormal heart rate patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

通过分析224例临床经验,对分娩期间胎儿的tcPco2测量值进行了评估。在心率模式可疑、病理前期或病理状态的病例中,这种额外的监测模式与连续胎心监护(CTG)和间歇性胎儿采血(FBA)联合进行。105例预先选定的测量温度为39℃,119例为44℃。在无缺氧并发症的病例中,通过计算平均值和两个标准差来定义tcPco2的正常范围。在未使用校正因子时,正常范围的绝对值因测量温度而异。通过Severinghaus公式将经皮测量值调整至血气水平后,两种应用温度(39℃和44℃)下的tcPco2值无显著差异。随着分娩进展,tcPco2明显升高。比较tcPco2值与胎儿血液中的pH值,我们发现在两种温度下均存在统计学显著相关性(p<0.001)。为了早期检测胎儿血液酸度升高,校正后55mmHg的行动线(44℃时为80mmHg,39℃时为63mmHg)是临床干预的适当依据,因为所有酸中毒(pH<7.20)和大多数酸中毒前期值(pH 7.20 - 7.24)均可排除。额外使用tcPco2有望带来的一项临床益处是,在许多心率模式异常的病例中减少胎儿采血的必要性。(摘要截选至250字)

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Fetal transcutaneous PCO2 measurements during labour.分娩期间胎儿经皮二氧化碳分压测量
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