孕妇产程中摄入能量电解质液体作用的多中心前瞻性研究  

A multi-center prospective study on the effect of intake of energy and electrolyte liquid in pregnant women during labor

作　　者：李琦 许雅君[2] 安琳 赵扬玉[4] 范玲[5] 蔡雁[6] 刘彩霞[7] 吴方银[8] 杨海澜[9] 孙丽洲[10] 贺晶[11] 马彦彦[12] 庞汝彦 LI Qi;XU Yajun;AN Lin;ZHAO Yangyu;FAN Ling;CAI Yan;LIU Caixia;WU Fangyin;YANG Hailan;SUN Lizhou;HE Jing;MA Yanyan;PANG Ruyan(Department of Obstetrics and Gynecology,the First Hospital of Tsinghua University,Beijing 100016,China;Department of Nutrition and Food Hygiene,School of Public Health,Peking University,Beijing 100191,China;Department of Maternal and Child Health,School of Public Health,Peking University,Beijing 100191,China;Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China;Department of Obstetrics and Gynecology,Beijing Obsterics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Department of Gynecology and Obstetrics,the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University,Shenyang 110004,China;Department of Obstetrics and Gynecology,Sichuan Provincial Materniry and Chid Health Care Hospital,Chengdu 610045,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasound,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Obstetrics,Women´s Hospital,School of Medicine,Zhejiang University,Hangzhou 310006,China;Department of Obstetrics and Gynecology,Tsinghua University Yuquan Hospital,Beijing 100049,China;Maternity and Child Health Association of China,Beijing 100089,China)

机构地区：[1]清华大学第一附属医院妇产科,北京100016 [2]北京大学医学部营养与食品卫生学系,北京100191 [3]北京大学医学部妇幼卫生学系,北京100191 [4]北京大学第三医院妇产科,北京100191 [5]首都医科大学附属北京妇产医院妇产科,北京100026 [6]哈尔滨医科大学附属第四医院妇产科,哈尔滨150001 [7]中国医科大学盛京医院妇产科,沈阳110004 [8]四川省妇幼保健院妇产科,成都610045 [9]山西医科大学第一医院妇产科,太原030001 [10]南京医科大学第一附属医院妇产科,南京210029 [11]浙江大学医学院附属妇产科医院妇产科,杭州310006 [12]清华大学玉泉医院妇产科,北京100049 [13]中国妇幼保健学会,北京100089

出　　处：《中国研究型医院》2021年第4期31-35,共5页Chinese Research Hospitals

基　　金：清华大学自主科研计划(20141081270)。

摘　　要：目的探讨孕妇产程中摄入能量电解质液体(EEEL)对孕妇和新生儿的影响。方法前瞻性收集2015年12月至2017年2月国内9家医院单胎头位的初产妇1988例,随机分为EEEL组1090例和自由饮食(FD)组898例。EEEL组的孕妇在产程中按照EEEL配方摄入能量电解质液体,FD组的孕妇自主摄入营养,记录两组饮食摄入类型和数量。比较两组孕妇和新生儿的尿酮体、呕吐情况,孕妇产程时间、分娩方式、产时出血量、血常规和电解质以及新生儿的脐静脉血血气值、出生体重和Apgar评分。结果产程中,EEEL组酮症变化和呕吐发生率明显低于FD组,差异有统计学意义(Z=-2.926,χ^(2)=5.330;P值均<0.05);两组中转剖宫产率比较差异无统计学意义(χ^(2)=5.128,P=0.078)。两组孕妇产程时间、产时出血量、血常规、血电解质以及新生儿脐静脉血血气值、出生体重和Apgar评分等比较差异均无统计学意义(P值均>0.05)。结论产程中采用EEEL方案能够降低孕妇酮症发生情况和呕吐发生率,对产程时间及母儿无不良影响,值得临床推广,该研究亦为产妇产程中进行能量补给提供理论依据,对于产程中孕妇入量管理具有一定指导意义。Objective To explore the effect of energy and electrolyte intake during labor on pregnant women and newborns.Methods From December 2015 to February 2017,a total of 1988 primiparas with singleton head position in 9 hospitals in China were prospectively collected and randomly divided into two groups:1090 cases in the energy enriched electrolyte liquid(EEEL)group and 898 cases in the free diet(FD)group.The pregnant women in the EEEL group ingested energy electrolyte fluids according to the EEEL formula during labor,and the pregnant women in the FD group took in nutrition independently during labor.The type and amount of dietary intake of the two groups were recorded.The urinary ketone body,vomiting of pregnant women and newborns between the two groups were compared.The duration of labor,delivery method,amount of bleeding during delivery,blood routine,and electrolytes were compared.The neonatal umbilical cord venous blood gas value,birth weight,and Apgar score were compared between the two groups.Results The changes in ketosis and the incidence of vomiting in the EEEL group were significantly lower than those in the FD group during labor,and the difference was statistically significant(Z=-2.926,χ^(2)=5.330;all P<0.05).There was no significant difference in the conversion rate to the cesarean section between the two groups(χ^(2)=5.128,P=0.078).There were no statistically significant differences in the duration of labor,amount of bleeding during delivery,blood routine,blood electrolytes,neonatal umbilical vein blood gas value,birth weight and Apgar score between the two groups of pregnant women(all P>0.05).Conclusions Using the EEEL regimen during labor can reduce pregnancy ketosis and vomiting,and there is no adverse effect on the time of labor and pregnant women and fetus.EEEL regimen is worthy of clinical promotion.This research also provides a theoretical basis for energy supplementation during labor,and has a certain guiding significance for the management of pregnant women´s intake during labor.

关 键 词：产程 新生儿 孕妇 能量电解质液体 自由饮食 

分 类 号：R714[医药卫生—妇产科学]