不同时间窗PCEA介入对高龄产妇妊娠结局影响的临床研究  

Clinical Study of the Influence of PCEA at Different Time Windows on Pregnancy Outcomes of Elderly Parturient Women

作　　者：梁丽笙[1] 周美娟[1] 梁晓红[1] Liang Lisheng;Zhou Meijuan;Liang Xiaohong(Department of Obstetrics,Nanhai District Maternal and Child Health Care Hospital,Foshan City,Guangdong Province,Foshan 528200)

机构地区：[1]广东省佛山市南海区妇幼保健院产科,佛山528200

出　　处：《数理医药学杂志》2021年第12期1739-1741,共3页Journal of Mathematical Medicine

基　　金：佛山市科技计划项目,项目名称:不同时间窗PCEA介入对高龄产妇妊娠结局影响的临床研究,编号:1920001001082。

摘　　要：目的:研究不同时间窗硬膜外自控镇痛(PCEA)介入对高龄产妇妊娠结局的影响。方法:选取2020年1月~2021年2月于某院分娩的高龄产妇60例作为研究对象,按随机数字表法分为A组和B组各30例,A组产妇于规律宫缩痛开始实施PCEA,B组于临产宫口开2cm开始实施PCEA,比较两组高龄产妇分娩疼痛程度、各产程时间、产后24h出血量、新生儿1min、5min的Apgar评分,并记录两组妊娠结局及新生儿窒息等发生情况。结果:A组第一产程潜伏期VAS评分低于B组(P<0.05),两组第一产程活跃期、产后6hVAS评分比较无显著差异(P>0.05);A组第一产程、第二产程及总产程时间短于B组(P<0.05),两组第三产程时间比较无统计学意义(P>0.05);A组产妇产时及产后24h出血量少于B组,新生儿1min、5min的Apgar评分高于B组(P<0.05);A组产妇自然分娩率高于B组,差异具有统计学意义(P<0.05),A组新生儿窒息率低于B组,但差异不具有统计学意义(P>0.05)。结论:规律宫缩痛开始实施PCEA及临产宫口开2cm开始实施PCEA均可取得较好的镇痛效果,但前者镇痛效果更为明显,且有助于缩短产程,提高自然分娩率,减少不良妊娠结局的发生,具有更好的临床推广价值。Objective:To study the influence of patient controlled epidural analgesia(PCEA)at different time windows on pregnancy outcomes of elderly parturient women.Methods:60 elderly parturient women treated in a hospital from January 2020 to February 2021 were selected as the study subjects and divided into group A and group B according to the random number table method,with 30 cases in each group.The parturient women in group A were given PCEA at the beginning of regular contractions,while parturient women in group B were given PCEA when the opening of the uterine orifice reached 2 cm.The degree of labor pain,duration of each stage of labor,24h postpartum blood loss,neonatal Apgar scores at 1 min and 5 min after birth were compared between the two groups.Pregnancy outcomes and occurrence of neonatal asphyxia in the two groups were recorded.Results:The VAS score in incubation period of the first stage of labor of group A was lower than that of group B(P<0.05).There was no significant difference between the two groups in terms of VAS scores in active phase of the first stage of labor and at 6h after delivery(P>0.05).The duration of the first stage of labor,duration of the second stage of labor,and the total labor time of group A were shorter than those of group B(P<0.05).There was no statistically significant difference in the duration of the third stage of labor between the two groups(P>0.05).The blood loss during delivery and in 24h after delivery of group A was less than that of group B.The 1min and 5min neonatal Apgar scores were higher than those of group B(P<0.05).The rate of natural delivery in group A was higher than that in group B,and the difference was statistically significant(P<0.05).The rate of neonatal asphyxia was lower than that in group B,but the difference was not statistically significant(P>0.05).Conclusion:Both PCEA at the beginning of regular contractions and PCEA when the opening of the uterine orifice reached 2 cm can achieve good analgesic effects.However,the former can obtain more obvious analges

关 键 词：硬膜外自控镇痛 介入时间 高龄产妇 妊娠结局 疼痛 产程 

分 类 号：R714.7[医药卫生—妇产科学]