脉冲式硬膜外注射与持续硬膜外注射自控分娩镇痛在瘢痕子宫妊娠阴道试产中的比较  

Comparison of two epidural delivery modes of labor analgesia in vaginal trial of scarred uterus pregnancy

作　　者：黄瑞平[1] 劳诚毅[1] 刘珍玉[1] HUANG Rui-ping;LAO Cheng-yi;LIU Zhen-yu(Department of Anesthesiology,Nanning Maternal&Child Health Hospital,Nanning 530011,China)

机构地区：[1]南宁市妇幼保健院麻醉科,广西南宁530011

出　　处：《吉林医学》2022年第1期22-24,共3页Jilin Medical Journal

基　　金：南宁市科学研究与技术开发计划项目[项目编号:20185066-6]。

摘　　要：目的:观察自动间歇脉冲式硬膜外注射联合硬膜外自控镇痛与持续硬膜外注射联合硬膜外自控镇痛(PCEA)分娩镇痛在瘢痕子宫妊娠阴道试产中的临床效果。方法:选取符合阴道试产且要求分娩镇痛的瘢痕子宫妊娠产妇100例,按随机数据表法分为两组:50例自动间歇脉冲式硬膜外注射复合PCEA为观察组,50例持续硬膜外注射复合PCEA为对照组。比较两组产妇疼痛视觉模拟量表(VAS)评分,所需硬膜外药液总量和自控加药次数及产妇满意度。结果:镇痛前、镇痛后产妇VAS评分,两组中转剖宫产率,产后出血量及新生儿出生1 min Apgar评分,差异无统计学意义(P>0.05)。观察组每小时所需镇痛液(8.5±2.4)ml,明显少于对照组[(11.3±2.1)ml],差异有统计学意义(P<0.05)。结论:自动间歇脉冲式硬膜外注射复合PCEA分娩镇痛用于瘢痕子宫妊娠阴道试产用药量更少,镇痛效果更佳且不增加剖宫产率。Objective To observe the clinical effect of automatic intermittent pulse epidural injection combined with patient-controlled epidural analgesia(PCEA)and continuous epidural injection combined with PCEA on labor analgesia in vaginal trial of scar uterus pregnancy.Method A total of 100 pregnant women with cicatricial uterus who met the requirements of vaginal trial and labor analgesia were randomly divided into two groups:50 cases of automatic intermittent pulse epidural injection combined with PCEA as the observation group and 50 cases of continuous epidural injection combined with PCEA as the control group.The VAS score,the total amount of epidural solution needed,the times of self-control administration and the satisfaction of the two groups were compared.Results There was no significant difference between the two groups in VAS score,cesarean section rate,postpartum hemorrhage and Apgar score in 1 min after birth(P>0.05).The analgesic solution(8.5±2.4)ml per hour in the observation group was significantly less than that in the control group[(11.3±2.1)ml],the difference was statistically significant(P<0.05).Conclusion Automatic intermittent pulse epidural injection combined with PCEA labor analgesia is worth popularizing for its less dosage,better analgesic effect and no increase of cesarean section rate.

关 键 词：自动间歇脉冲式注射 瘢痕子宫 阴道试产 硬膜外分娩镇痛 

分 类 号：R714.3[医药卫生—妇产科学]