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孕产妇及产后高镁血症与胎粪栓综合征

Maternal and postnatal hypermagnesemia and the meconium plug syndrome.

作者信息

Cooney D R, Rosevear W, Grosfeld J L

出版信息

J Pediatr Surg. 1976 Apr;11(2):167-72. doi: 10.1016/0022-3468(76)90281-5.

Abstract

Thirty dated pregnant Srague-Dawley rats received IM MgSO4 (750 mg/kg/ X 5 days) until birth. Fifteen untreated pregnant Sprague-Dawley rats of similar gestation served as controls. A total of 453 rats were born. Ninety neonates (two from each of 45 liters) were randomly removed before suckling, sacrificed, and the water content of the meconium and serum magnesium determined. The remaining 363 bewborn rats were observed for delayed passage of meconium or abdominal distention. Hypermagnesemic (6.3 +/- 0.5 mg/100 ml) neonates had neither abdominal distention nor delayed passage of meconium. The water content of meconium in hypermagnesemic rats (84.7 +/- 4.2% and in untreated controls (85.5 +/- 3.8%) were statistically similar. Dated pregnant mongrel dogs were given magnesium sulfate by continuous intravenous infusion and by bolus intravenous injection. The water content of meconium, transit time, and basic electrical rhythm (BER) of treated neonates were similar to untreated neonatal controls. The water content of meconium, transit time, and BER of neonatal dogs made hypermagnesemic (12.0 +/- 1.2 mg/100 ml) in the postnatal period were similar tp untreated neonatal controls. In adult and newborn pupies, receiving a continuous intravenous magnesium sulfate infusion, deep tendon reflexes ceased at serum magnesium levels of 9.0-10.0 mg/100 ml, spontaneous respiration at 14.0-15.0 mg/100 ml, and BER was suppressed (transiently) at 20.0-25.0 mg/10 ml. These data suggest that high (sublethal) doses of MgSO4 in pregnant and newborn animals have little effect on BER, meconium transit time or water content of the neonates. No correlation between MgSO4 treatment and the meconium plug syndrome was observed in the experiments.

摘要

30只妊娠的斯普拉格-道利大鼠从妊娠开始至分娩接受硫酸镁肌肉注射(750毫克/千克,共5天)。15只妊娠情况相似的未接受治疗的斯普拉格-道利大鼠作为对照。共出生453只大鼠。90只新生大鼠(45窝中每窝2只)在哺乳前被随机取出、处死,并测定胎粪的含水量和血清镁含量。其余363只新生大鼠被观察是否有胎粪排出延迟或腹胀。高镁血症(6.3±0.5毫克/100毫升)的新生大鼠既没有腹胀也没有胎粪排出延迟。高镁血症大鼠胎粪的含水量(84.7±4.2%)与未治疗对照组(85.5±3.8%)在统计学上相似。对妊娠的杂种狗持续静脉输注硫酸镁并静脉推注。治疗组新生犬的胎粪含水量、转运时间和基本电节律(BER)与未治疗的新生对照组相似。出生后使新生犬发生高镁血症(12.0±1.2毫克/100毫升),其胎粪含水量、转运时间和BER与未治疗的新生对照组相似。在成年和新生幼犬中,持续静脉输注硫酸镁,当血清镁水平达到9.0 - 10.0毫克/100毫升时深部腱反射消失,14.0 - 15.0毫克/100毫升时自主呼吸停止,20.0 - 25.0毫克/10毫升时BER被(短暂)抑制。这些数据表明,在妊娠和新生动物中高剂量(亚致死剂量)的硫酸镁对新生动物的BER、胎粪转运时间或含水量影响很小。在实验中未观察到硫酸镁治疗与胎粪栓塞综合征之间的相关性。

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