硬膜外分娩镇痛在妊娠期高血压产妇中的效果及对妊娠结局的影响
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摘要
目的探讨妊娠期高血压产妇在硬膜外分娩镇痛的临床效果。方法将95例妊娠期高血压产妇采用随机数字表法进行分组,对照组47例给予腰-硬膜外阻滞麻醉分娩镇痛,观察组48例给予硬膜外分娩镇痛。观察比较两组产妇镇痛后舒张压、收缩压、下肢运动神经阻滞程度、疼痛、缩宫素使用率、产程时间及妊娠结局情况。结果观察组产妇镇痛后5 min、活跃期及第二产程收缩压、舒张压均低于对照组,下肢运动神经阻滞程度0级高于对照组,1级低于对照组,第一、第二产程时间以及缩宫素使用率、剖宫产率均低于对照组,自然分娩高于对照组,组间比较差异均有统计学意义(P<0.05)。两组患者的视觉模拟评分、Apgar评分及下肢运动神经阻滞程度2级比较均无统计学意义(P>0.05)。结论硬膜外分娩镇痛效果佳,降压平稳,能有效缩短妊娠期高血压产妇产程时间,减少缩宫素使用率,提升自然分娩率,且安全性高。
Objective To investigate the effect of epidural labor analgesia in puerper with hypertensive pregnancy. Methods A total of 95 pregnant women with gestational hypertension were randomly divided into two groups.The control group(47 patients) received analgesia with lumbar-epidural anesthesia for anesthesia,and observation group(48 patients) underwent epidural labor analgesia.Diastolic blood pressure,systolic blood pressure,lower limb motor block,pain,oxytocin use rate,labor time and pregnancy outcome after maternal analgesia of two groups were observed and compared. Results The systolic blood pressure and diastolic blood pressure of the observation group were lower than that of the control group at 5 min,active period,and second stage of labor.The degree of lower limb motor block was higher than that of the control group,and the level 1 was lower than the control group.The first and second stage of labor,oxytocin use rate,cesarean section rate were lower than the control group,and natural delivery was higher than the control group(P<0.05).VAS,Apgar score and lower limb motor block level 2 and the control group were not statistical significance(P>0.05). Conclusion Epidural labor analgesia has good analgesic effect,stable blood pressure,effective shortening of maternal labor time during pregnancy,reduction of oxytocin use rate,increase of natural delivery rate,and high safety.
Objective To investigate the effect of epidural labor analgesia in puerper with hypertensive pregnancy. Methods A total of 95 pregnant women with gestational hypertension were randomly divided into two groups.The control group(47 patients) received analgesia with lumbar-epidural anesthesia for anesthesia,and observation group(48 patients) underwent epidural labor analgesia.Diastolic blood pressure,systolic blood pressure,lower limb motor block,pain,oxytocin use rate,labor time and pregnancy outcome after maternal analgesia of two groups were observed and compared. Results The systolic blood pressure and diastolic blood pressure of the observation group were lower than that of the control group at 5 min,active period,and second stage of labor.The degree of lower limb motor block was higher than that of the control group,and the level 1 was lower than the control group.The first and second stage of labor,oxytocin use rate,cesarean section rate were lower than the control group,and natural delivery was higher than the control group(P<0.05).VAS,Apgar score and lower limb motor block level 2 and the control group were not statistical significance(P>0.05). Conclusion Epidural labor analgesia has good analgesic effect,stable blood pressure,effective shortening of maternal labor time during pregnancy,reduction of oxytocin use rate,increase of natural delivery rate,and high safety.
引文
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[6] 李姝,车向明,徐铭军,等.脊椎-硬膜外联合阻滞分娩镇痛对妊娠期高血压产妇IL-2、 TNF-α及血压的影响[J].北京医学,2015,37(7):658-661.
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[8] 陈微,朱贵琴,梁刚.硬膜外分娩镇痛对妊娠期高血压产妇产程时间、血压及分娩结局的影响[J].中国妇幼保健,2018,33(6):1254-1257.
[2] 中华医学会妇产科学分会妊娠期高血压疾病学组.妊娠期高血压疾病诊治指南(2015)[J].中华妇产科杂志,2015,50(10):721-728.
[3] 易杰,黄宇光,罗爱伦.罗哌卡因用于腰麻-硬膜外联合阻滞的临床观察[J].中华麻醉学杂志,2000,20(1):26-28.
[4] 王国林,徐铭军,王子千.妇产科麻醉学[M].第2版.北京:科学出版社,2012:578-582.
[5] 杨沫,魏东红,王岩岩.罗哌卡因复合芬太尼硬膜外麻醉分娩镇痛对子痫前期患者母婴的影响研究[J].中国药业,2015,24(21):43-44.
[6] 李姝,车向明,徐铭军,等.脊椎-硬膜外联合阻滞分娩镇痛对妊娠期高血压产妇IL-2、 TNF-α及血压的影响[J].北京医学,2015,37(7):658-661.
[7] 于坚伟,鲁花丽.腰-硬联合阻滞镇痛在合并妊娠期高血压疾病产妇中的应用[J].中国计划生育和妇产科,2016,8(9):32-35.
[8] 陈微,朱贵琴,梁刚.硬膜外分娩镇痛对妊娠期高血压产妇产程时间、血压及分娩结局的影响[J].中国妇幼保健,2018,33(6):1254-1257.