硬膜外分娩镇痛对新生儿脐血低氧诱导因子-1α含量的影响  

Effect of epidural anesthesia for labor analgesia on the level of hypoxia inducible factor-1αin umbilical cord blood

作　　者：郭祺 杨保仲[2] 王辉[2] 郝丽兵 GUO Qi;YANG Baozhong;WANG Hui;HAO Libing(School of Anesthesiology,Shanxi Medical University,Taiyuan,Shanxi 030001,China;Depart-ment of Anesthesiology,First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Anesthesiology,Jinzhong Maternal and Child Health Care Hospital,Jinzhong,Shanxi 030001,China)

机构地区：[1]山西医科大学麻醉学院,山西太原030001 [2]山西医科大学第一医院麻醉科,山西太原030001 [3]晋中市妇幼保健院麻醉科,山西晋中030000

出　　处：《安徽医药》2020年第10期1986-1989,共4页Anhui Medical and Pharmaceutical Journal

基　　金：晋中市科技重点研发计划项目(Y173001)。

摘　　要：目的评价硬膜外分娩镇痛对新生儿脐动脉血低氧诱导因子-1α(HIF-1α)含量的影响。方法选择2018年8月至2019年2月晋中市妇幼保健院健康单胎初产妇64例,依据自愿接受硬膜外分娩镇痛原则分为镇痛组30例,对照组34例。镇痛组:采用自控硬膜外镇痛,待宫口开至3 cm时,于L2-3间隙行硬膜外穿刺,置入硬膜外导管并连接镇痛泵。对照组:自愿放弃镇痛措施,按正常自然分娩程序处理。记录两组产妇的镇痛效果(采用Mulleetr镇痛强度评分法)、不同产程阶段脐动脉血流S/D值、新生儿Apgar评分、脐动脉血气;采用ELISA法测定脐动脉中HIF-1α的含量。结果镇痛组Mulleetr评分≤2分所占比例(80.00%)明显高于对照组(29.41%),差异有统计学意义(χ^2=16.379,P<0.01);镇痛组HIF-1α为(14.34±0.32)ng/L与对照组的(14.52±0.41)ng/L比较,差异无统计学意义(t=1.877,P=0.065);两组脐动脉血流S/D值不同产程阶段组间比较差异无统计学意义(P>0.05);两组新生儿Apgar评分、脐动脉血气结果分析比较,差异无统计学意义(P>0.05)。结论硬膜外分娩镇痛不影响新生儿脐动脉血HIF-1α含量,是一种安全有效的镇痛方法。Objective To evaluate the effect of epidural labor analgesia on hypoxic-inducible factor-1α(HIF-1α)content in neonatal umbilical arterial blood.Methods Sixty-four healthy singleton primiparas inWomen Health Center of Jinzhong from August 2018 to February 2019 were selected.According to the principle of voluntary epidural labor analgesia,30 patients in the analgesicgroup(E)and 34 patients in the control group(C).Group E:When the cervix dilation was opened to 3 cm,epidural puncture wasperformed in the L2-3 intervertebral space,and an epidural catheter was placed and connected to an analgesia pump.Group C:Volun-tary abandonment measures were taken and treated according to normal natural delivery procedures.The analgesic effect of the twogroups of women(using the Mulleetr analgesia intensity score),the umbilical arterial blood flow S/D value at different stages of la-bor,the neonatal Apgar score,and the umbilical arterial blood gas were measured.ELISA method was used to determine the level ofHIF-1αin the umbilical artery.ResultsThe proportion of mulleetr score≤2 in the analgesia group(80.00%)was significantlyhigher than that in the control group(29.41%),andthe difference was statistically significant(χ^2=16.379,P<0.01).The HIF-1αinthe analgesia group was(14.34±0.32)ng/L,which was not significantly different from that in the control group[(14.52±0.41)ng/L](t=1.877,P=0.065).There was no significant difference in the S/D values of the umbilical arterial blood flow between the twogroups(P>0.01).There were no significant differences in Apgar score,arterial blood gas results(P>0.01).ConclusionEpidurallabor analgesia does not affect the content of HIF-1αin neonatal umbilical arterial blood,which is a safe and effective analgesicmethod.

关 键 词：镇痛 产科 镇痛 硬膜外 镇痛 病人控制 缺氧诱导因子1 Α亚基 脐动脉 超声检查 多普勒 彩色 

分 类 号：R714.3[医药卫生—妇产科学]