硬脊膜穿破硬膜外阻滞技术在产妇分娩镇痛中的应用效果  

Application effect of epidural block with dural perforation in parturient analgesia

作　　者：陈秋月 陈文玉 关则雄 CHEN Qiu-yue;CHEN Wen-yu;GUAN Ze-xiong(Operation Room of Anesthesiology Department,Yangjiang Maternal and Child Health Hospital,Guangdong Province,Yangjiang 529500,China;Department of Nuclear Medicine,Yangjiang Peoples′Hospital,Guangdong Province,Yangjiang 529500,China)

机构地区：[1]广东省阳江市妇幼保健院麻醉科手术室,广东阳江529500 [2]广东省阳江市人民医院核医学科,广东阳江529500

出　　处：《中国当代医药》2021年第22期162-165,共4页China Modern Medicine

基　　金：广东省阳江市科技计划项目(SF2020091)。

摘　　要：目的探讨硬脊膜穿破硬膜外(DPE)阻滞技术在产妇分娩镇痛中的应用效果。方法选取2019年1月—2020年10月阳江市妇幼保健院收治的325例分娩镇痛的足月初产妇为研究对象,按照掷硬币法分为DPE组(170例)和EP组(155例)。DPE组采用硬脊膜穿破硬膜外麻醉,EP组采用硬膜外麻醉。比较两组产妇分娩镇痛并发症发生率、不同分娩阶段视觉模拟量表(VAS)评分、镇痛泵按压次数(PCA)、下肢运动神经阻滞程度(Bromage)评分。结果DPE组的并发症胎心异常、产前发热、皮肤瘙痒、排尿困难、产后头痛的发生率低于EP组,差异有统计学意义(P<0.05);不同分娩阶段DPE组的VAS评分均低于EP组,差异有统计学意义(P<0.05);DPE组PCA按压次数少于EP组,Bromage评分低于EP组,差异有统计学意义(P<0.05)。结论DPE阻滞技术在产妇分娩镇痛中应用效果显著,安全性较高,值得临床应用推广。Objective To investigate the effect of epidural puncture(DPE)block in parturient labor analgesia.Methods A total of 325 cases of full-term diparas who were admitted to Yangjiang Maternal and Child Health Hospital from January 2019 to October 2020 were selected as the research subjects,and divided into DPE group(170 cases)and EP group(155 cases)according to the method of coin toss.DPE group received epidural puncture anesthesia,and EP group received epidural anesthesia.The incidence of analgesic complications,visual analogue scale(VAS)score,the number of analgesic pump compressions(PCA)and the degree of lower limb motor nerve block(Bromage)score were compared between the two groups.Results The incidences of complications as fetal heart abnormality,prenatal fever,skin itching,dysuria and postpartum headache in DPE group were lower than those in EP group,and the differences were statistically significant(P<0.05).VAS score of DPE group were lower than those of EP group at different stages of delivery,the differences were statistically significant(P<0.05).PCA pressing frequency of DPE group was lower than that of EP group,and Bromage score was lower than that of EP group,the differences were statistically significant(P<0.05).Conclusion DPE block technique has obvious effect and high safety in childbirth analgesia,which is worthy of clinical application and promotion.

关 键 词：硬脊膜穿破硬膜外阻滞技术 分娩镇痛 有效性 安全性 

分 类 号：R614[医药卫生—麻醉学]