半固体食物用于硬膜外分娩镇痛产妇能量补充的效果  

Effect of semisolid food on energy supplement in parturients undergoing epidural labor analgesia

作　　者：史媛[1] 董贝贝[1] 谢克亮[1] 于泳浩[1] Shi Yuan;Dong Beibei;Xie Keliang;Yu Yonghao(Department of Anesthesiology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院麻醉科,300052

出　　处：《中华麻醉学杂志》2020年第7期855-858,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价半固体食物用于硬膜外分娩镇痛产妇能量补充的效果。方法选择头胎无妊娠合并症、自愿接受分娩镇痛的产妇90例,孕38~41周,年龄20~35岁,BMI 19~30 kg/m2,采用随机数字表法分为3组(n=30):清亮无渣运动饮料组(A组)、小米粥组(B组)和半固体食物组(C组)。分别于入院后空腹饮用300 ml清水后、分娩镇痛前和分娩镇痛1 h空腹给予不同类型食物后,采用超声胃窦单切面法测定胃排空时间。分娩镇痛后期按需饮用不同类型食物至第三产程结束即刻。第三产程结束即刻采用VAS评价产妇饥饿、口渴和疲劳程度。记录产程时间、饮食总量、单位时间供能、产钳助产情况、镇痛泵按压次数、产程中恶心呕吐发生情况和产后出血量。结果与分娩镇痛前比较,分娩镇痛后3组胃排空时间延长(P<0.05);与A组比较,B组和C组分娩镇痛后胃排空时间延长,饥饿和疲劳程度评分降低,饮食总量降低,单位时间供能增加,B组恶心呕吐发生率升高,C组恶心呕吐发生率降低(P<0.05);与B组比较,C组分娩镇痛后胃排空时间缩短,疲劳程度评分降低,单位时间供能增加,呕吐发生率降低(P<0.05)。3组口渴程度评分、产程时间、产钳助产率、产后出血量、镇痛泵按压次数比较差异无统计学意义(P>0.05)。结论与运动饮料和小米粥相比,半固体食物用于硬膜外分娩镇痛产妇能量补充的效果更佳。Objective To evaluate the effect of the semisolid food on the energy supplement in the parturients undergoing epidural labor analgesia.Methods Ninety parturients requesting epidural labor analgesia with no pregnancy complications,at 38-41 week gestation,aged 20-35 yr,with body mass index of 19-30 kg/m2,were divided into 3 groups(n=30 each)using a random number table method:sports drink group(group A),millet gruel group(group B)and semisolid food group(group C).After admission to the hospital,different types of food were given on an empty stomach after drinking 300 ml of water,before labor analgesia and 1 h of labor analgesia,and the gastric emptying time(GET)was measured by the ultrasound assessment of gastric antrum.In the late stage of labor analgesia,patients drank different types of food as needed until the end of the third stage of labor.Visual analogue scale score was used to evaluate the maternal starvation,thirst and fatigue immediately after the end of the third stage of labor.The duration of labor,total amount of diet,energy supply per unit time,forceps-assisted vaginal delivery,pressing times of patient-controlled analgesia,occurrence of nausea and vomiting during labor,and volume of postpartum hemorrhage were recorded.Results GET was significantly longer after labor analgesia than before labor analgesia in the three groups(P<0.05).Compared with group A,GET was significantly prolonged after labor analgesia,scores for starvation and fatigue and total amount of diet were decreased,and the energy supply per unit time was increased in group B and group C,and the incidence of nausea and vomiting was significantly increased in group B and decreased in group C(P<0.05).Compared with group B,GET was significantly shortened after labor analgesia,scores for fatigue were decreased,the energy supply per unit time was increased,and the incidence of vomiting was decreased in group C(P<0.05).There were no statistically significant differences among the three groups in scores for thirst,duration of labor,incidence of f

关 键 词：分娩镇痛 镇痛 硬膜外 能量摄取 半固体食物 

分 类 号：R714.3[医药卫生—妇产科学]