摘要
目的观察不同时机及不同针刺留针时间针刺穴位联合硬膜外分娩镇痛应用于自然分娩的效果。方法选取2017年4月—2019年6月期间自贡市妇幼保健院产科待产产妇350例。根据针刺穴位时机及针刺留针时间的不同,将纳入研究的受试者按随机数字表法分为7组:A组(宫口开≤1 cm+留针30 min)、B组(宫口开1.1~2.0 cm+留针30 min)、C组(宫口开2.1~2.9 cm+留针30 min)、D组(宫口开≤1 cm+留针60 min)、E组(宫口开1.1~2.0 cm+留针60 min)、F组(宫口开>2.0 cm+留针60 min)、G组不针刺,每组各50例。7组均接受硬膜外麻醉。针刺选穴头针、体针、常规针刺双侧太冲、足三里、内关,针刺得气后加用电针仪。观察各组针刺及硬膜外阻滞镇痛前后疼痛数字评分法(Numeric rating scales,NRS)、各产程时间、新生儿Apgar评分及分娩方式。结果治疗后7组产妇NRS评分均较治疗前降低,差异有统计学意义(P<0.05);且7组产妇组间NRS评分比较,以G组-F组-A组-B组-C组-D组-E组顺序明显降低,差异有统计学意义(P<0.05)。治疗后7组产妇潜伏期、第一产程比较,差异有统计学意义(P<0.05),潜伏期以G组-A组-B组-C组-D组-F组-E组顺序降低,第一产程及总产程以G组-C组-B组-A组-F组-D组-E组顺序降低。7组产妇第二产程和第三产程比较,差异无统计学意义(P>0.05),E组潜伏期、第一产程及总产程时间均较其他6组产妇明显缩短,差异有统计学意义(P<0.05)。7组产妇均无死胎,7组产妇新生儿1 min Apgar评分比较,差异无统计学意义(P>0.05)。A、B、C、G组均有自然分娩转剖宫产。结论针刺穴位联合硬膜外阻滞镇痛最佳方案为宫口开大1.1~2.0 cm,行针刺分娩镇痛,留针60 min,镇痛效果明显,缩短产程,提高分娩安全性。
Objective To investigate the application of acupuncture(at different time points and with different needle retention time)combined with epidural block for pain relief in natural childbirth.Methods A total of 350 women who were going to give birth in the Delivery Room,Zigong Hospital of Women and Children Healthcare from April 2017 to June 2019 were enrolled in this study.According to the different time points and needle retention time of acupuncture,the women were assigned with the random number table method into 7 groups(n=50):A(cervix opening for≤1 cm+needle retention for 30 min),B(cervix opening for 1.1~2.0 cm+needle retention for 30 min),C(cervix opening for 2.1~2.9 cm+needle retention for 30 min),D(cervix opening for≤1 cm+needle retention for 60 min),group E(cervix opening for 1.1~2.0 cm+needle retention for 60 min),F(cervix opening for>2.0 cm+needle retention for 60 min),and G(no acupuncture).All the groups received epidural anesthesia.Acupuncture was performed on the head acupoints,body acupoints,and both sides of Taichong(LR3),Zusanli(ST36),Neiguan(PC6),and electroacupuncture was performed after qi was obtained.Before and after acupuncture and epidural block,the numerical rating scale(NRS)score,the time of each labor stage,the neonatal Apgar score,and the mode of delivery were recorded in each group.Results After treatment,the NRS of the 7 groups were significantly decreased,and the decrease was in an order of group G>group F>group A>group B>group C>group D>group E.The incubation period and the first stage of labor varied in the 7 groups(P<0.05).Specifically,the incubation period decreased in an order of group G>group A>group B>group C>group D>group F>group E,and the first stage of labor and total stage of labor were shortened in an order of group G>group C>group B>group A>group F>group D>group E.Neither the second nor the third stage of labor showed significant differences among the seven groups(P>0.05).Group E showed shorter incubation period,first stage of labor,and total stage of labor than other
作者
付天静
林玉仙
李利
黄琳
刘琴
黄浩
袁茜
罗云先
高冰
FU Tian-jing;LN Yu-xian;LI Li;HUANG Lin;LIU Qin;HUANG Hao;YUAN Qian;LUO Yun-xian;GAO Bing(Department of Integrated Traditional Chinese and Western Medicine,Zigong Hopital of Women and Children Healthcare,Zigong Sichuan 643010;Department of Anesthesiology,Zigong Hospital of Women and Children Healthcare,Zigong Sichuan 643010;Delivery Room,Zigong Hospital of Women and Children He althcare,Zigong Sichuan 643010;Depart-ment of Child Healtheare,Zigong Hospital of W omen and Children Healtheare,Zigong Sichuan 643010)
出处
《世界中西医结合杂志》
2023年第12期2417-2421,共5页
World Journal of Integrated Traditional and Western Medicine
基金
四川省科技计划项目(2019YJ0065)
2017年自贡市重点科技计划项目(2017SF06)。
关键词
针刺
硬膜外阻滞镇痛
自然分娩
Acupuncture
Epidural Block for Pain Relief
Natural Childbirth
