耳穴磁珠贴压对分娩镇痛中产妇体温、炎性反应及胎盘病理结果的影响  

Effect of auricular magnetic bead pressing on maternal body temperature,inflammatory response and placental pathological results in labor analgesia

作　　者：文婷[1] 李干[1] 陈世彪[1] 刘佳 WEN Ting;LI Gan;CHEN Shi-biao;LIU Jia(Department of Anesthesiology,The First Affiliated Hospital of Nanchang University,Nanchang 330000,China;Laboratory Medicine,Mental Hospital of Jiangxi Province,Nanchang 330000)

机构地区：[1]南昌大学第一附属医院麻醉科,南昌330000 [2]江西省精神病院检验科,南昌330000

出　　处：《针刺研究》2020年第12期1010-1013,共4页Acupuncture Research

基　　金：江西省重点研发计划项目(No.20181BBG78033);江西省卫生计生委科技计划(No.20185116)。

摘　　要：目的:观察耳穴磁珠贴压对硬膜外分娩镇痛中产时发热(ERMF)的影响,并探讨其对母体炎性反应的作用。方法:将自愿行分娩镇痛的产妇随机分为硬外组79例和耳穴组81例。两组均行硬膜外分娩镇痛,耳穴组在硬膜外阻滞基础上取神门、内生殖器、内分泌、交感穴行耳穴磁珠贴压。记录产妇分娩镇痛前(T1)、无痛分娩后2 h(T2)、无痛分娩后4 h(T3)和胎儿娩出时(T4)的鼓膜温度,并计算两组ERMF发生率。记录产妇总产程时间、镇痛时间、自控硬膜外镇痛(PCEA)按压次数和分娩镇痛药量、剖宫产率等情况,并比较两组产妇血清白细胞介素(IL)-6水平和胎盘病理结果。结果:两组产妇的总产程时间、镇痛时间和剖宫产率差异无统计学意义(P>0.05)。耳穴组PCEA按压次数和分娩镇痛药量少于硬外组(P<0.05)。两组产妇于T1时鼓膜温度差异无统计学意义(P>0.05),T3和T4时鼓膜温度较T1时升高(P<0.05);耳穴组T3和T4时的鼓膜温度和ERMF发生率均低于硬外组(P<0.05)。两组产妇产后血清IL-6水平均较产前升高(P<0.05);耳穴组产后血清IL-6水平和绒毛膜羊膜炎(HCA)阳性率均低于硬外组(P<0.05)。结论:耳穴磁珠贴压可有效减少硬膜外分娩镇痛中局麻药的用量,抑制硬膜外镇痛前介导的母体炎性反应,有利于避免ERMF的发生。Objective To observe the effects of auricular magnetic bead pressing on maternal body temperature,inflammatory response and placental pathological results in epidural labor analgesia.Methods 180 parturient who volunteered for labor analgesia were randomly divided into epidural group(n=90,epidural labor analgesia)and auricular pressing group(n=90,epidural labor analgesia combined auricular pressing).The tympanic temperature before labor analgesia(T1),2 h(T2),4 h(T3)and 4 h after labor analgesia(T4)were recorded.The total duration of labor,duration of labor analgesia,PCEA compression times,labor analgesia dose,cesarean section rate was counted,and the changes in serum IL-6 level and placental pathology results of the two groups were analyzed.Results There was no significant difference in age,BMI,gestational age,duration of labor,duration of analgesia and rate of cesarean section between groups(P>0.05).Times of PCEA compressions and labor analgesic dose in auricular group were lower than that in epidural group(P<0.05).There was no difference in tympanic temperature between two groups at T1(P>0.05),and the tympanic temperature at T3 and T4 was higher than that at T1(P<0.05).The tympanic temperature in T3 and T4,and incidence of intrapartum fever in the auricular group was lower than that in the epidural group(P<0.05).There was no difference in the prenatal serum IL-6 level between groups(P>0.05),and the postpartum serum IL-6 level was higher than that before labor in either group(P<0.05).The postpartum serum IL-6 level and the incidence of HCA in the auricular point group were lower than those in epidural group(P<0.05).Conclusion Magnetic beads auricular pressing therapy has advantages in reducing intrapartum fever by modulating maternal inflammation and reducing the dosage of local anesthetics effectively during epidural labor analgesia.

关 键 词：耳穴贴压疗法 分娩镇痛 产时发热 炎性因子 绒毛膜羊膜炎 

分 类 号：R245.32[医药卫生—针灸推拿学]