Effects Of Pre-filling Colloid On The Myocardial Enzymes And Troponin In Maternal And Neonatal Rats

Now the use of cesarean section in the obstetrics and delivery of the fetus has become increasingly common,cesarean section surgery has higher requirements on the anesthesiologist,not only need to consider the maternal safety,painless,but also consider how to reduce fetal perinatal Mortality,improve neonatal prognosis [1,2].Cesarean section surgery anesthesia can lead to maternal hemodynamic abnormalities,abnormal maternal hemodynamic abnormalities are one of the common causes of acute fetal distress.When the maternal blood pressure below a certain level will lead to fetal asphyxia.Fetal asphyxia can cause a series of lesions,including hypercapnia,hypoxemia and acidosis and eventually develop into acidosis,fetal distress if not corrected in time,may cause stillbirth or stillbirth,may also continue until after birth.it's an important cause of perinatal myocardial injury,brain damage and death.Therefore,we need to explore how to prevent fetal distress caused by changes in maternal hemodynamics caused by anesthesia leading to neonatal myocardial injury,brain damage or death.The aim of this study is in the spinal anesthesia before cesarean section anesthesia given maternal intravenous colloid expansion fluid,to observe the maternal hemodynamics and neonatal umbilical artery blood cardiac enzymes and troponin changes,to explore whether preoperative colloidal colloid can reduce the incidence of neonatal asphyxia,thereby improving the safety of cesarean section fetal surgery.Method:1.The experimental group: select the hospital 80 cases of cesarean section as the object of this study,divided into two groups randomly,each group was divided into 40 cases,one group for the use of colloid pre-expansion group,another was not using colloid pre-expansion group,the maternal age of pre-expansion group were 21-37 years old,average age were(26.9±3.1)years old,gestational age were 37 to 42 weeks,mean(39.7 ± 0.5)weeks,the maternal age of the two groups was 23 to 39 years old,and the average age(27.4 ± 3.3)years old,37 to 42 weeks gestation week,mean(39.8 ± 0.6 weeks),the mother and children were no genetic,metabolic and immune diseases,according to the American Association of Anesthesiologists physical condition grading standards(ASA)[ 3,4] for the ? ~ ? maternal,all mothers in the preoperative heart,lung,liver,kidney,coagulation function were no obvious abnormalities,the choice of 80 cases of maternal success were patients with spinal anesthesia,failure spinal anesthesia or switch to other anesthesia maternal were not included in study,the study has been applied to our hospital and approved by the Ethics Committee of our institute.2.Methods and observation indicators: the LDH in umbilical artery blood in newborn,CK-MB,CK,AST,CTN and pre-anesthesia(T1),1 min after anesthesia(5 min after anesthesia),10 min after anesthesia,and 10 min after anesthesia(T4),fetal delivery(T5),fetal heart rate,diastolic blood pressure,systolic blood pressure,and arterial oxygen saturation at 10 min after delivery(T6).And record whether patients with nausea,vomiting,hypotension and other adverse reactions.Followed by record Apgar score and PH,PaCO2,PaO2 indicators of newborns.3.Statistical processing: The data were statistically analyzed by SPSS16.0 software.The data were expressed by the standard deviation(S),the statistical method was t test and linear regression correlation analysis,with P <0.05 significance.Result:1.Comparison of the two neonates groups about the levels of LDH,CK-MB,CK,AST and CTN :the level of LDH?CK-MB?CK?AST?CTN in the neonates of pre-expansion group were lower than those in the control group,the difference was statistically significant Meaning(p <0.01).2.Comparison of the two neonates groups about the levels of PH,PaO2 and PaCO2: in the neonates of the two groups were higher than those in the control group,and the PaO2 was lower than that of the control group(p <0.05).3.The heart rate,oxygen saturation,respiratory rate,systolic blood pressure and diastolic blood pressure of T1,T2,T3,T4,T5 and T6 were compared between the two groups: there was no significant difference in heart rate,oxygen saturation and respiration between the pre-expansion and the control group(P> 0.05).The systolic blood pressure and diastolic blood pressure in the preoperative expansion group were higher than those in the control group.The difference between the two groups was statistically significant(p <0.05).Conclusion:1.preoperative intravenous infusion of colloidal fluid can increase neonatal umbilical artery blood PH value,improve neonatal oxygen partial pressure,reduce neonatal carbon dioxide partial pressure,effectively reduce the incidence of neonatal asphyxia.2.preoperative intravenous infusion of colloid dilatation can reduce neonatal umbilical artery blood cardiac enzyme and calcium protein concentration,suggesting that colloid expansion agent on myocardial tissue and brain tissue has a protective effect.3.preoperative intravenous infusion of colloidal dilatation can maintain the stability of maternal hemodynamics more advantages to ensure that the mother of the fetal blood perfusion,neonatal ischemia and hypoxia caused by intrauterine distress has a preventive effect.