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作 者:周维纲[1] 王宇波 杨建治 郑名辉 王燕[1] 张汉湘[1] 张建标[2] ZHOU Weigang;WANG Yubo;YANG Jianzhi(Hanzhong Central Hospital,in Shaanxi Province,Hanzhong 723000)
机构地区:[1]陕西省汉中市中心医院,汉中723000 [2]汉中职业技术学院,汉中723000
出 处:《陕西医学杂志》2019年第8期1074-1076,1097,共4页Shaanxi Medical Journal
基 金:陕西省汉中市中心医院院级科研基金中标项目(YK17016)
摘 要:目的:探讨右美托咪定对分娩镇痛产妇产程及脐动脉血气的影响。方法:分娩镇痛的足月(37~42孕周)初产妇90例,单胎、头位、ASAⅠ~Ⅱ级,年龄22~32岁,BMI<35 kg/m2,随机分为右美托咪定组(A组,n=45)和对照组(C组,n=45)。记录产妇入产房时(T1)、硬膜外注射负荷量后20 min (T2)、宫口开6~8 cm(T3)、宫口开全(T4)、胎儿娩出时(T5)的产妇视觉模拟评分(VAS)。记录第一产程(潜伏期、活跃期),第二产程,第三产程时限及催产素使用情况。胎儿娩出后行脐动脉血气分析。结果:与C组比较,A组产妇T3 、T4、T5时间点VAS评分明显降低(P<0.05);A组产妇T2、T3、T4、T5较T1时间点VAS评分明显降低(P<0.05);C组产妇T2、T3、T4、T5较T1时间点VAS评分降低(P<0.05);C组产妇T2、T4、T5时间点VAS评分明显高于T3(P<0.05)。两组产妇第一产程(潜伏期、活跃期)、第二产程、第三产程及催产素使用率,组间比较无统计学差异(P>0.05)。两组胎儿脐动脉血pH值、氧分压(PaO2)、二氧化碳分压(PaCO2)、碱剩余(BE)、乳酸(Lac),组间比较无统计学差异(P>0.05)。两组新生儿第1、5 min Apgar评分,组间比较无统计学差异(P>0.05)。结论:分娩镇痛时静脉辅助右美托嘧定是一种安全有效的方法。Objective:To explore the effect of dexmedetomidine on the delivery duration and umbilical artery blood gas of painless parturient.Methods:Requirements of epidural term(37~42 gestational age) 90 cases of primipara, singletons, head, ASA Ⅰ~Ⅱ grade, age 22 to 32 years old, BMI<35 kg/m2, were randomly divided into dexmedetomidine group(group A, n=45) and control group(group C,n=45).Visual simulation scores(VAS) were recorded when the woman entered the delivery room(T1), 20 min after epidural injection(T2), 6-8 cm of the uterine orifice(T3), complete uterine opening(T4) and delivery of the fetus(T5).The duration of the first(latency, activity), second and third stage of labor was recorded, and the amount of oxytocin was recorded.Blood gas analysis of umbilical artery was performed after fetal delivery.Results:Compared with group C, the VAS scores of the T3, T4 and T5 time points of the parturients in group A were significantly reduced(P<0.05).In group A, the VAS scores of T2, T3, T4 and T5 of the patients were significantly lower than T1(P<0.05).In group C, the VAS scores of T2, T3, T4 and T5 of the patients were lower than T1(P<0.05).The VAS scores of patients in group C at time points T2, T4 and T5 were significantly higher than T3(P<0.05).There was no statistical significant difference in terms of the first, second, and third stage of labor, and the amount of oxytocin used between the two group cases(P>0.05).There was no statistically significant difference in fetal umbilical arterial blood pH, PaO2, PaCO2, BE and lactate between the two groups(P>0.05).Apgar score at 1 min and 5 min in the two groups showed no statistically significant difference(P>0.05).Conclusion:Intravenous dexmedetomidine for labor analgesia is safe and effective adjuvant method.
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