硬脊膜穿破硬膜外阻滞技术在分娩镇痛中的临床研究  

Clinical Study of Dural Puncture Epidural in Labor Analgesia

作　　者：张清[1] 李斌[1] 宗斯 ZHANG Qing;LI Bin;ZONG Si(Jiujiang Maternal and Child Health Hospital,Jiangxi Province,Jiujiang 332000,China;不详)

机构地区：[1]江西省九江市妇幼保健院,江西九江332000

出　　处：《中国医学创新》2022年第10期127-130,共4页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202120065)。

摘　　要：目的:探讨硬脊膜穿破硬膜外(DPE)阻滞技术在分娩镇痛中的应用效果。方法:选取2019年5月-2021年5月九江市妇幼保健院收治的120例足月待产妇,按随机数字表法分为对照组(n=60),观察组(n=60)。对照组给予硬膜外阻滞,观察组予以DPE阻滞,观察至患者出院。对比两组镇痛情况、疼痛程度、各产程时间及新生儿情况、不良反应发生情况。结果:观察组罗哌卡因用量、舒芬太尼用量、手动推注药物次数均少于对照组,镇痛起效时间、视觉模拟疼痛量表(VAS)评分降至3分及以下时间均短于对照组,差异均有统计学意义(P<0.05);镇痛前(T_(0)),两组VAS评分相比,差异无统计学意义(P>0.05);镇痛后5 min(T_(1))、镇痛后30 min(T_(2))、镇痛后60 min(T_(3))、宫口全开(T_(4))、分娩(T_(5))时,观察组VAS评分均低于对照组,差异均有统计学意义(P<0.05);两组胎儿娩出后的1、5 min新生儿Apgar评分相比,差异均无统计学意义(P>0.05)。观察组第一、二、三产程时间均短于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。结论:DPE阻滞用于产妇分娩镇痛中对母婴无不良影响,可缩短镇痛起效时间,减少麻醉药物使用量与手动推注药物次数,减轻产妇疼痛程度,促进产程进展,有效降低不良反应发生率,安全可行。Objective:To explore the effect of dural puncture epidural(DPE)in labor analgesia.Method:A total of 120 full-term pregnant women admitted to Jiujiang Maternal and Child Health Hospital from May 2019 to May 2021 were selected and divided into the control group(n=60)and the observation group(n=60)according to a random number table.The control group was given epidural(EP)block,the observation group was given DPE block,and the patients were observed until the patients were discharged.The analgesic situation,the degree of pain,the time of each stage of labor,the condition of the newborn and the adverse reactions were compared between the two groups.Result:The dosage of Ropivacaine,Sufentanil and the number of manual boluses in the observation group were less than those in the control group,the onset time of analgesia and the time when the score of visual analog pain scale(VAS)dropped to 3 points or less were shorter than those in the control group,the differences were statistically significant(P<0.05);before analgesia(T_(0)),there was no significant difference in VAS scores between the two groups(P>0.05);5 minutes after analgesia(T_(1)),30 minutes after analgesia(T_(2)),60 minutes after analgesia(T_(3)),full uterine opening(T_(4)),delivery(T_(5)),the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05);there were no significant differences in neonatal Apgar score between the two groups at 1 and 5 minutes after delivery(P>0.05);the time of the first,second and third stage of labor in the observation group were shorter than those in the control group,and the incidence of adverse reactions was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:The application of DPE block in parturient analgesia has no adverse effects on the mothers and infants,it can shorten the analgesic onset time,reduce the use of anesthetics and the number of manual injections,reduce the pain of the parturient,prom

关 键 词：分娩镇痛 硬脊膜穿破硬膜外阻滞 产程时间 不良反应 

分 类 号：R714.3[医药卫生—妇产科学]