摘要
目的比较全产程分娩镇痛与第一产程分娩镇痛用于合并妊娠高血压综合征产妇的安全性及有效性。方法选择2015年3~11月于北京妇产医院分娩的产妇196例,年龄22~35岁,ASAⅠ或Ⅱ级。所有产妇均为初产、单胎和足月妊娠,诊断妊娠高血压综合征。随机将入选产妇分为全产程分娩镇痛组(T组)和第一产程活跃期分娩镇痛组(F组)。T组在出现子宫规律收缩后进行分娩镇痛,持续应用镇痛泵至第三产程结束;F组在出现子宫规律收缩且进入第一产程活跃期(子宫口开至3cm)后进行分娩镇痛,子宫口开全后,由生理盐水代替泵内麻醉药物至第三产程结束。记录镇痛前、镇痛后10、60min、宫口开全、第二产程屏气用力和胎头娩出时的MAP和VAS评分;记录应用缩宫素例数和第二产程屏气用力时Bromage评分;记录第一、第二、第三产程时间、分娩方式、子痫和产后出血情况。结果第二产程屏气用力时,T组MAP明显低于F组[(106.0±7.0)mm Hg vs.(115.4±7.3)mm Hg,P<0.05],VAS评分明显低于F组[(2.0±1.1)分vs.(5.1±1.2)分,P<0.05];胎头娩出时,T组MAP明显低于F组[(106.2±7.2)mm Hg vs.(116.0±7.6)mm Hg,P<0.05],VAS评分明显低于F组[(1.9±1.2)分vs.(5.2±1.3)分,P<0.05];T组应用缩宫素例数明显多于F组[50(51%)vs.35(35%),P<0.05]。两组Bromage评分、产程时间、分娩方式和相关不良反应差异无统计学意义。结论全产程分娩镇痛可安全有效地应用于合并妊娠高血压综合征的产妇。
Objective To compare the safety and efficacy of whole stage and first stage of labor analgesia on puerperas with pregnancy-induced hypertension syndrome.Methods From March,2015 to November,2015,196 single fetus,aged 22-35 years,term pregnancy,primipara,ASA physical statusⅠ orⅡ,diagnosed pregnancy-induced hypertension syndrome,were randomly divided into the whole stage of labor analgesia group（group T）and the first stage of labor analgesia group（group F）.Patients in group T received labor analgesia after uterine contractions regularly,and continued the labor analgesia to the end of the delivery;patients in group F received labor analgesia after uterine contractions regularly and the uterus cervix was 3cm,in the end of the first stage of labor,using the normal saline instead of the medicine.The MAP and VAS score were recorded before analgesia and 10 minutes,60minutes after the beginning of analgesia,when the uterine cervix dilated absolutely,the second stage of labor and when the fetal is delivered.The Bromage scores were recorded at the second stage of labor.The time for the first stage of labor,the second stage of labor and the third stage of labor were recorded.The mode of delivery,the incidence of eclampsia,postpartum hemorrhage,the use of oxytocin and antihypertensive in the delivery progress were recorded.The neonate weight,Apgar score and the cord blood gas analysis were recorded.Results At the uterine cervix dilated absolutely and the second stage of labor,the MAP [（106.0±7.0）mm Hg vs.（115.4±7.3）mm Hg,（106.2±7.2）mm Hg vs.（116.0±7.6）mm Hg]and VAS score[（2.0±1.1）scores vs.（5.1±1.2）scores,（1.9±1.2）scores vs.（5.2±1.3）scores]in group T were lower than those in group F（P〈0.05）.The patients who received oxytocin in group T were more than that in group F[50（51%）vs.35（35%）,P〈0.05].Conclusion The whole stage labor epidural analgesia is safe and effective for puerperas with pregnancy-induced hypertension syndrome.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2017年第2期109-112,共4页
Journal of Clinical Anesthesiology
基金
北京市卫生和计划生育委员会科技成果和适宜技术推广项目(TG-2014-12)
关键词
妊娠高血压综合征
分娩镇痛
产程
新生儿
Pregnancy-induced hypertension syndrome
Labor analgesia
Labor progress
Neonate
