口服碳水化合物对硬膜外分娩镇痛产妇产程中舒适度的影响  

Effect of oral carbohydrate solution intake on the maternal comfort of parturients who accepted epidural labor analgesia

作　　者：丁婷[1] 崔凡[1] 曲元[1] 王东信[1] DING Ting;CUI Fan;QU Yuan;WANG Dongxin(Department of Anesthesiology, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院麻醉科,100034

出　　处：《临床麻醉学杂志》2018年第6期534-537,共4页Journal of Clinical Anesthesiology

摘　　要：目的观察口服碳水化合物对接受硬膜外分娩镇痛产妇产程中舒适度的影响。方法选择接受硬膜外分娩镇痛的单胎、头位、足月初产妇90例,年龄24~39岁,BMI 21~39kg/m^2,ASAⅡ级,随机分为两组:口服碳水化合物组(CHO组,n=46)和对照组(C组,n=44)。在接受分娩镇痛后,CHO组饮用术能,C组饮用无渣液体,第三产程后两组均停止饮用液体。记录两组饮用时长、液体总量,计算两组液体供能;记录产程时长、分娩方式、PCEA镇痛泵按压次数、药物总量和产程中呕吐的发生情况;记录分娩镇痛后即刻以及第三产程结束即刻饥饿、口渴、疲劳程度NRS评分。结果CHO组饮用液体总量少于C组,但差异无统计学意义[(129.5±28.8)ml vs(142.4±53.3)ml,P=0.15],CHO组液体供能明显多于C组[(312.2±69.5)kJ/h vs(153.9±96.7)kJ/h,P<0.01]。两组液体饮用时长、产程时长、分娩方式、镇痛泵药物总量差异无统计学意义。CHO组镇痛泵按压次数明显少于C组[0.6(0~11.6)次vs 2(0~8.6)次,P=0.03]。CHO组产程中呕吐的比例明显低于C组[3例(6.5%)vs 10例(22.7%),P=0.03]。第三产程后即刻CHO组饥饿NRS评分[2(0~9)分vs 6(0~10)分,P<0.01]、疲劳程度[3(2~8)分vs 4(1~7)分,P=0.04]明显低于C组。两组口渴NRS评分差异无统计学意义。结论口服碳水化合物作为接受硬膜外分娩镇痛产妇产程中的能量补充饮品可以降低产妇的饥饿疲劳程度,可降低产程中呕吐发生率,增加产妇的分娩舒适度。Objective To observe the influence of oral carbohydrate solution intake on the maternal comfort of parturients who accepted epidural labor analgesia.Methods Ninety parturients requesting epidural labor analgesia,who were at full term（37-42 weeks of gestation）with a singleton fetus in vertex presentation,aged 24-39 years,BMI 21-39 kg/m^2,ASA physical statusⅡ,were randomly divided into oral carbohydrate groups（group CHO,n = 46）and control group（group C,n= 44）.After the epidural labor analgesia was done,parturients in group CHO were requested to intake oral carbohydrate solution（outfast）while parturients in group C were requested to intake no particle clear liquid（mostly,sports drink or water）.The intake of liquid ceased after the third stage of labor.The information of the liquid intake of two groups,including the duration of liquid intake,amount of liquid were recorded while the energy provided by liquid was calculated.The perinatal information,mode of delivery,duration of labor,the PCEA times,the amount of analgesia agents used,the ratio of vomiting were recorded.The NRS of starvation,thirst and fatigue after taking labor analgesia and after the third stage were recorded.Results There was no statistical difference of the duration of liquid intake between the two groups.The amount of liquid intake in group CHO was fewer than that in group C,but not statistically different（129.5 ± 28.8 ml vs 142.4 ± 53.3 ml,P =0.15）;the energy supplied in group CHO was obviously more than that in group C（312.2 ± 69.5 kJ/h vs 153.9±96.7 kJ/h,P〈0.01）.The times of PCEA per hour in group CHO were obviously fewer than those in group C [0.6（0-11.6）vs 2（0-8.6）,P = 0.03].The ratio of vomiting in group CHO was lower than that in group C [3 cases（6.5%）vs 10 cases（22.7%）,P = 0.03].Starvation NRS[2（0-9）vs 6（0-10）,P〈0.01]and fatigue NRS[3（2-8）vs 4（1-7）,P = 0.04]of group CHO was lower than that of group C.Conclusion As an energy supplier during labor,carbohydrate can provide c

关 键 词：口服碳水化合物 硬膜外分娩镇痛 饥饿 呕吐 

分 类 号：R714.3[医药卫生—妇产科学]