摘要
目的探讨妊娠期糖尿病(GDM)产程中应用硬膜外麻醉、蛛网膜下腔麻醉联合脊椎麻醉(腰-硬联合麻醉,CSEA)分娩镇痛对母婴的影响。方法将该院2013年11月-2015年4月GDM初产妇62例纳为研究对象,将其分为观察组和对照组,每组患者各31例,观察组患者给予CSEA分娩镇痛,对照组患者采用常规镇痛方式(非药物性镇痛法或者笑气)。结果观察组患者活跃期平均持续时间较对照组患者短(P<0.05);两组患者平均潜伏期时间、第二产程平均持续时间比较差异均无统计学意义(P>0.05);观察组患者活跃期的末梢血糖水平处于相对稳定状态,且活跃期各个时间点的末梢血糖值均低于对照组患者(P<0.05);观察组患者活跃期T4时静脉血皮质醇(Cor)较对照组低(P<0.05);观察组新生儿脐带血Cor较对照组低(P<0.05);观察组新生儿血糖水平较对照组高(P<0.05);两组新生儿Apgar评分比较差异无统计学意义(P>0.05)。结论在妊娠期糖尿病产妇产程中应用分娩镇痛,可有效缩短活跃期时间,控制血糖及皮质醇水平稳定,改善新生儿血糖,可获得良好的母婴结局。
【Objective】To explore the effect of combined spinal-epidural analgesia（epidural anesthesia, subarachnoid anesthesia, spinal anesthesia）（CSEA） on gestational diabetes mellitus（GDM） primiparas and newborns.【Methods】Sixty-two cases of primiparas with GDM admitted in our hospital from November 2013 to Apirl 2015 were elected, 31 cases received CSEA were regarded as observation group, and the others received routine analgesia（non drug analgesia or nitrous oxide） were regarded as control group.【Results】The average duration of the active phase in the observation group was significantly shorter than that in the control group（P〈0.05）, but the average incubation period and the average duration of second labor between the two groups were not significantly different（P〉0.05）; the blood sugar level in the observation group was relatively stable, and the blood sugar values at different time points in the observation group were significantly lower than those in the control group during the active phase（P〈0.05）; the serum cortisol（Cor） in the observation group was significantly lower than that in the control group in end of the active phase（P〈0.05）; the umbilical cord blood Cor in the observation group was significantly lower than that in the control group（P〈0.05）, and the blood sugar level of neonate in the observation group was significantly higher than that in the control group（P〈0.05）; the Apgar grade of two groups was not significantly different（P〉0.05）.【Conclusion】Application of the combined spinal-epidural analgesia in primiparas with gestational diabetes mellitus can effectively shorten the active phase, control the blood sugar and serum cortisol stably, and obtain a good neonate outcomes.
出处
《中国医学工程》
2016年第11期25-27,共3页
China Medical Engineering
关键词
妊娠期糖尿病
产程
分娩镇痛
母儿结局
gestational diabetes mellitus
labor
combined spinal-epidural analgesia
neonate outcomes
