硬膜外自控联合硬膜外间歇脉冲输注分娩镇痛对新生儿Apgar评分及窒息的影响  

The effect of patient-controlled epidural analgesia combined with intermittent epidural bolus for labor analgesia on Apgar score and asphyxia of neonates

作　　者：吴演文 张春元[1] 吴靦 曾伟[1] 谭美云[1] 陈茂芳[1] 朱贺权 WU Yan-wen;ZHANG Chun-yuan;WU Mian(Department of Anesthesiology,Zhongshan Boai Hospital,Zhongshan 528400,China)

机构地区：[1]中山市博爱医院麻醉科,528400

出　　处：《中国实用医药》2021年第27期21-23,共3页China Practical Medicine

基　　金：中山市医学科研项目(项目编号:2019A020334),项目名称:脉冲泵输注用于硬膜外分娩镇痛对新生儿脐带血血气的影响。

摘　　要：目的分析探讨硬膜外自控联合硬膜外间歇脉冲输注分娩镇痛对新生儿Apgar评分及窒息的影响。方法300例阴道分娩产妇,随机分为A组、B组和C组,每组100例。A组产妇接受硬膜外间歇脉冲输注联合自控硬膜外分娩镇痛,B组产妇接受持续泵注联合自控硬膜外分娩镇痛,C组产妇未行分娩镇痛。比较三组血气指标、产程以及新生儿出生后1、5、10 min的Apgar评分和窒息情况。结果A组、B组新生儿pH、氧分压(PO_(2))、二氧化碳分压(PCO_(2))及血乳酸(LAC)比较,差异均无统计学意义(P>0.05);C组新生儿pH、PO_(2)、PCO_(2)、LAC与A组、B组比较,差异均有统计学意义(P<0.05)。A组第一产程(421.87±78.65)min短于B组的(509.87±56.42)min、C组的(514.77±56.22)min,差异均具有统计学意义(P<0.05)。三组产妇第二产程与第三产程比较,差异均无统计学意义(P>0.05)。A组新生儿出生后1 min的Apgar评分(9.16±0.22)分均高于B组的(8.45±0.65)分和C组的(8.35±0.57)分,新生儿出生后5 min的Apgar评分(9.32±0.32)分均高于B组的(8.89±0.35)分和C组的(8.86±0.44)分,差异均具有统计学意义(P<0.05)。三组新生儿出生后10 min的Apgar评分比较,差异均无统计学意义(P>0.05)。三组均未出现因窒息而死亡的新生儿。结论硬膜外自控联合硬膜外间歇脉冲输注分娩镇痛效果显著。Objective To analyze the effect of epidural patient-control analgesia combined with intermittent epidural bolus for labor analgesia on Apgar score and asphyxia of neonates.Methods A total of 300 pregnant women with vaginal delivery were randomly divided into group A,group B and group C,with 100 cases in each group.Women in group A received intermittent epidural bolus combined with patient-controlled epidural analgesia for labor analgesia,women in group B received continuous pumping combined with patientcontrolled epidural analgesia for labor analgesia,and women in group C received no labor analgesia.The blood gas indexes,labor process,Apgar score and asphyxia score at 1,5 and 10 min after birth were compared among the three groups.Results There was no statistically significant difference in pH,partial pressure of oxygen(PO_(2)),partial pressure of carbon dioxide(PCO_(2))and blood lactic acid(LAC)among neonates in group A and group B(P>0.05);there were statistically significant differences in PH,PO_(2),PCO_(2) and LAC among neonates in group C and group A,group B(P<0.05).The first stage of labor(421.87±78.65)min in group A was shorter than(509.87±56.42)min in group B and(514.77±56.22)min in group C,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the second stage of labor and the third stage of labor among the three groups(P>0.05).The Apgar score(9.16±0.22)points of neonates in group A at 1 min after birth was higher than(8.45±0.65)points in group B and(8.35±0.57)points in group C,and the Apgar score(9.32±0.32)points of neonates at 5 min after birth was higher than(8.89±0.35)points in group B and(8.86±0.44)points in group C.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the Apgar scores of neonates at 10 min after birth among the three groups(P>0.05).There were no neonates who died of asphyxia in the three groups.Conclusion Combination of patient-controlled epidural analgesia and i

关 键 词：硬膜外自控镇痛 硬膜外间歇脉冲输注 新生儿Apgar评分 窒息 

分 类 号：R714.3[医药卫生—妇产科学]