穴位针刺联合硬膜外麻醉在分娩镇痛中的临床应用价值  

Clinical application value of acupoint acupuncture combined with epidural anesthesia in labor analgesia

作　　者：郝小姣 肖欢 赵艳 HAO Xiaojiao;XIAO Huan;ZHAO Yan(Department of Obstetrics and Gynecology,Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China;Department of Anesthesiology,Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海市宝山区中西医结合医院妇产科,上海201900 [2]上海市宝山区中西医结合医院麻醉科,上海201900

出　　处：《重庆医学》2021年第12期2022-2024,2029,共4页Chongqing medicine

基　　金：上海市中医药三年行动计划中医特色诊疗技术提升项目[ZY(2018-2020)-ZYJS-17];上海市宝山区科委项目(17-E-13)。

摘　　要：目的探讨穴位针刺联合硬膜外麻醉在分娩镇痛中的临床应用价值。方法选取2018年5月至2020年5月该院收治的90例产妇为研究对象,分为对照组、参考组、观察组,每组30例。对照组采用穴位针刺,参考组采用硬膜外麻醉,观察组采用穴位针刺联合硬膜外麻醉。观察各组疼痛评分、宫腔压力、产程指标、转归情况。结果观察组NPIS评分、5-羟色胺(5-HT)水平低于对照组和参考组,血清β-内啡肽水平高于对照组和参考组,差异有统计学意义(P<0.05)。观察组不同时点宫腔压力、第二产程时间、潜伏期时间、活跃期时间与对照组、参考组比较差异无统计学意义(P>0.05)。观察组剖宫产率、催产素使用率、产钳或剖宫产率低于对照组、参考组,新生儿Apgar评分高于对照组、参考组,差异有统计学意义(P<0.05)。结论采用穴位针刺联合硬膜外麻醉为分娩产妇镇痛时可有效降低疼痛评分,改善宫腔压力、产程指标、转归情况。Objective To investigate the clinical application value of acupoint acupuncture combined with epidural anesthesia in labor analgesia.Methods Ninety parturients in this hospital from May 2018 to May 2020 were selected as the research subjects and divided into the control group,reference group and observation group,30 cases in each group.The control group adopted the acupoint acupuncture,the reference group adopted the epidural anesthesia and the observation group adopted the acupoint acupuncture combined with epidural anesthesia.The pain score,uterine pressure,labor process indicators and outcomes were observed in each group.Results The NPIS score and 5-HT level in the observation group were lower than those in the control group and reference group,serumβ-endorphin level in the observation group was higher than that in the control group and reference group,and the differences were statistically significant(P<0.05);the difference in the uterine pressure at different time points,time of the second stage of labor,time of latency period and time of active period between the observation group with the control group and reference group had no statistical significance(P>0.05)The cesarean section rate,oxytocin use rate,obstetric forceps use rate or cesarean section rate in the observation group were lower than those in the control group and reference group,and the differences were statistically significant(P<0.05).Conclusion Acupoint acupuncture combined with epidural anesthesia in analgesia for parturients can effectively reduce the pain score,improve the uterine pressure,labor process indicators and outcome.

关 键 词：穴位针刺 硬膜外麻醉 分娩镇痛 宫腔压力 剖宫产 

分 类 号：R245.95[医药卫生—针灸推拿学]