智能化病人自控镇痛泵用于分娩镇痛的临床观察  

Clinical study of intelligent patient-controlled analgesia pump for labor analgesia

作　　者：李姗[1] 董铁立[1] LI Shan;DONG Tie-li(Department of Anesthesiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第二附属医院麻醉科,河南郑州450000

出　　处：《广东医学》2020年第11期1124-1127,共4页Guangdong Medical Journal

摘　　要：目的评价智能化病人自控镇痛(artificial intelligence patient-controlled analgesia,Ai-PCA)泵用于分娩镇痛的临床效果.方法选择进行分娩的产妇86例,随机分为两组:智能自控镇痛泵组(I组,n=42)和常规分娩对照组(C组,n=44),I组给予硬膜外智能化自控镇痛进行分娩镇痛,Ai-PCA泵参数的设置为首次负荷量7 mL,持续背景剂量5 mL/h,锁定时间15 min,追加量(Bolus)5 mL/h(<20 mL/h).C组给予导乐陪伴或心理安慰.记录产妇镇痛前(T0)、分娩镇痛后30 min(T1)、宫口开全(T2)、第二产程用力分娩时(T3)的平均动脉压(MAP)、心率(HR)及VAS评分,记录新生儿Apgar评分,记录产妇可能发生的发热、恶心呕吐及寒战等不良反应的发生率,记录产妇及医护人员满意度.结果I组有2例、C组有4例产妇因胎位不正或产程进展不顺利结束分娩中转剖宫产,最终纳入产妇I组40例,C组40例.与C组比较,I组T1~T3时间点的MAP、HR、VAS评分降低(P<0.05);与C组比较,I组产妇镇静评分、发热发生率、产妇及医护人员满意度升高(P<0.05);两组产妇新生儿Apgar评分、恶心呕吐及寒战的发生率差异无统计学意义(P>0.05).结论Ai-PCA泵用于分娩镇痛临床效果确切,母婴安全,不仅产妇及医护人员较为满意,而且还能够提高分娩镇痛的管理质量,Ai-PCA泵优于传统常规导乐陪伴及心理安慰的阴道分娩.Objective To evaluate the effect of artificial intelligence patient-controlled analgesia(Ai-PCA) pump for labor analgesia. Methods Eighty-six primiparas who give birth were randomly divided into two groups, the intelligent self-controlled analgesic pump set group(Group I, n=42), and the conventional delivery control group(Group C, n=44). Group I was given with epidural intelligent controlled analgesia for labor analgesia. Ai-PCA pump parameters were set as the first load of 7 mL, the sustained background dose of 5 mL/h, the locking time of 15 min, and the additional amount(Bolus) of 5 mL/h(<20 mL/h). Group C was given with doula accompany or psychological comfort. The mean arterial pressure(MAP), the heart rates(HR) and the VAS scores were recorded before labor analgesia(T0), 30 min after analgesia(T1), at the open of the uterus(T2) and at hard labor during the second stage(T3). The Apgar scores of the neonates was recorded. The primiparas′ and medical staffs′ satisfaction levels were recorded. The incidence of possible adverse reactions such as fever, nausea, vomiting and chills were compared. Results There were 2 cases in Group I and 4 cases in Group C transferred to cesarean section after delivery due to abnormal fetal position or poor labor progress. Finally, 40 cases in Group I and 40 cases in Group C were included. Compared with Group C, the MAP, the HR and the VAS scores of Group I were significantly reduced from T1 to T3(P<0.05). Compared with Group C, the maternal sedation scores, the fever rate and the satisfaction levels of primiparas and medical staffs of Group I were significantly increased(P<0.05).There was no significant difference in apgar scores, nausea, vomiting or chills between the two groups(P>0.05). Conclusion The intelligent patient-controlled analgesia pump is effective for labor analgesia and safe for mothers and babies. Not only primiparas and medical staffs are satisfied, but it can also improve the management of labor analgesia. The Ai-PCA pump is superior to the traditional routin

关 键 词：分娩镇痛 病人自控镇痛 智能化 

分 类 号：R714.3[医药卫生—妇产科学] R614.42[医药卫生—临床医学]