硬膜外阻滞联合针刺分娩镇痛的可行性及安全性  

Feasibility and security of acupuncture combined with epidural analgesia for labor and delivery

作　　者：卢丽雅[1] 麦冠梁 

机构地区：[1]广州医科大学附属第一医院,广州510120 [2]广州市钟村医院

出　　处：《山东医药》2014年第7期33-35,共3页Shandong Medical Journal

基　　金：广州市医药卫生科技项目(201122231021)

摘　　要：目的探讨硬膜外阻滞联合针刺分娩镇痛的可行性和安全性。方法 66例要求行分娩镇痛的初产妇随机分为硬膜外阻滞联合针刺镇痛组(Ⅰ组)和硬膜外阻滞镇痛组(Ⅱ组),每组33例。分别于镇痛前(T1)、硬膜外镇痛后30 min(T2)、1 h(T3)和宫口开全(T4)4个时点,观察宫腔压力、宫缩间歇、宫缩持续时间及VAS评分。记录分娩过程硬膜外镇痛用药量、催产素总用量、第二及第三产程时间、最终分娩方式、产后出血量、新生儿1 min及5min的Apgar评分以及脐静脉血气分析。结果两组VAS评分、第二及第三产程时间、子宫收缩情况、新生儿1 min及5 min时Apgar评分、分娩结局等差异均无统计学意义(P>0.05)。Ⅰ组硬膜外用药量为(17.45±4.83)mL,Ⅱ组为(20.18±5.34)mL,两组比较P<0.05。Ⅰ组催产素总用量为(21.69±1.44)U,Ⅱ组为(22.93±1.76)U,两组比较P<0.01。结论硬膜外阻滞与针刺联合用于分娩镇痛,可减少局麻药及催产素用量,且安全性好。Objective To evaluate the feasibility and security of acupuncture combined with epidural analgesia for la- bor and delivery. Methods Sixty-six primiparae were randomly divided into group I （n = 33） which exposed to acupunc- ture combined with epidural analgesia and group I1 （ n = 33） which exposed to single epidural analgesia. Visual analog scale （VAS）, pressure of uterine cavity, interval and persistence time of uterine contractions was recorded at the end of the following time points ： （T1 ） before analgesia, （T2 ） after 30 min of epidural analgesia, （T3 ） after 60 min of epidural anal- gesia, and （T4） uterine neck whole opened. Recorded measures were dose of anesthetic or oxytocin, time length of the second or third stage, mode of delivery, postpartum blood loss, neonateg Apgar scores at 1 min and 5 min and blood gas a- nalysis of umbilical vein. Results There were no significant differences between the two groups in VAS, time length of the second or third stage, uterine contractions, neonateg Apgar scores at 1 min and 5 min and parturition outcome （P 〉 0.05）. The total dose of local anesthetic was （17.45 ±4.83） mL in the group I and （20. 18±5.34） mL in the group Ⅱ （P〈 0.05）. The total dose of oxytocin was （21.69 ±1.44） U in the group I and （22.93±1.76） U in the group Ⅱ （P〈 0.01 ）. Conclusion Acupuncture combined with epidural analgesia reduces the dosage of local anesthetic and oxytocin for labor and delivery with good security.

关 键 词：分娩 硬膜外镇痛 针刺 三阴交 合谷穴 SANYINJIAO (SP6) HEGU (LI4) 

分 类 号：R614.3[医药卫生—麻醉学] R714.3[医药卫生—外科学]