地佐辛复合低浓度盐酸罗哌卡因硬膜外自控分娩镇痛对高龄初产妇应激反应及产后盆底功能影响  

Influence of dizosin combined with low concentration ropivacaine hydrochloride for patient-controlled epidural labor analgesia of elderly primipara on their stress response and postpartum pelvic floor function

作　　者：陈琳 赵文静 CHEN Lin;ZHAO Wenjing(Xuzhou Maternal and Child Health Care Hospital, Jiangsu Province, 221000;Affiliated Hospital of Xuzhou Medical University)

机构地区：[1]徐州医科大学附属徐州市妇幼保健院,221000 [2]徐州医科大学附属医院

出　　处：《中国计划生育学杂志》2022年第1期72-75,共4页Chinese Journal of Family Planning

基　　金：江苏省妇幼保健协会科研项目(FYX201806)。

摘　　要：目的:探讨地佐辛复合低浓度盐酸罗哌卡因硬膜外自控分娩镇痛对高龄初产妇分娩应激反应及产后盆底功能的影响。方法:选取本院2019年1月-2020年1月收治的≥35岁初产妇100例,根据镇痛不同分为两组各50例。对照组接受地佐辛注射液静注做分娩镇痛,观察组行地佐辛复合低浓度盐酸罗哌卡因硬膜外自控分娩镇痛。对比两组分娩时间、分娩出血量、住院时间、疼痛评分(VAS评分),应激反应指标去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、丙二醛(MDA)、超氧化物歧化酶(SOD),产后盆底肌力功能、会阴损伤程度、产后不良反应并发症情况。结果:观察组分娩时间(4.3±1.2h)、分娩出血量(262.3±30.6ml)、住院时间(6.1±3.2d)、VAS评分均低于对照组,分娩过程中NE、AngⅡ、MDA水平低于对照组,SOD水平高于对照组,产妇会阴损伤程度低于对照组,盆底肌力及功能优于对照组,不良反应及并发症发生率低于对照组(均P<0.05)。结论:采用地佐辛复合低浓度盐酸罗哌卡因行硬膜外自控分娩镇痛可显著减轻产妇疼痛感,有效降低产妇分娩应激反应,减少对产后盆底功能损伤、会阴损伤,降低产后并发症。Objective:To investigate the influence of dizosin combined with low concentration ropivacaine hydrochloride for patient-controlled epidural labor analgesia of elderly primipara on their stress response and postpartum pelvic floor function.Methods:A total of 100 elderly primiparas were selected and divided into two groups(50 cases in each group)according to different analgesia methods from January 2019 to January 2020.The primiparas in the control group had received intravenous dezocine injection for labor analgesia,and the primiparas in the study group had received dezocine combined with low-concentration ropivacaine hydrochloride patient-controlled epidural labor analgesia.The delivery time,the bleeding loss during delivery,the hospitalization time,the VAS score,the values of stress response index,such as norepinephrine(NE),angiotensinⅡ(AngⅡ),malondialdehyde(MDA),superoxide Dismutase(SOD),and the situations of postpartum pelvic floor muscle function,perineal damage,and postpartum adverse reactions and complications of the primiparas were compared between the two groups.Results:The labor time(4.3±1.2h),blood loss during delivery(262.3±30.6ml),time of hospital stay(6.1±3.2d),and the VAS score of the primiparas in the observation group were all significantly lower than those of the primiparas in the control group.The levels of NE,AngⅡ,and MDA during delivery of the primiparas in the observation group were significantly lower than those of the primiparas in the control group,while the level of SOD of the primiparas in the observation group was significantly higher.The degree of perinaeum injury,muscle strength,and function of pelvic floor of the primiparas in the observation group were significantly better than those of the primiparas in the control group,and the incidences of adverse reactions and complications of the primiparas in the observation group were significantly lower than those of the primiparas in the control group(all P<0.05).Conclusion:Dezocine combined with low-concentration ropivacaine hydr

关 键 词：高龄产妇:分娩镇痛 地佐辛 盐酸罗哌卡因 硬膜外自控 氧化应激 镇痛效果 盆底功能损伤 

分 类 号：R47[医药卫生—护理学]