程控硬膜外间歇脉冲注入技术应用于分娩镇痛中的效果  

Effect of Programmed Intermittent Epidural Boluses on Labor Analgesia

作　　者：钟海林 ZHONG Hailin(Family Planning Service Center of Xingning Maternal and Child Health Hospital,Xingning 514500,China)

机构地区：[1]兴宁市妇幼保健院计划生育服务中心,广东兴宁514500

出　　处：《中外医学研究》2022年第11期133-136,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨程控硬膜外间歇脉冲注入(PIEB)技术和持续硬膜外输注(CEI)模式在分娩镇痛中的应用效果。方法:按计算机分组法将兴宁市妇幼保健院计划生育服务中心2018年10月-2020年5月进行分娩的63例孕妇分为常规组(n=31,分娩镇痛中给予CEI模式麻醉)和试验组(n=32,分娩镇痛中给予PIEB技术麻醉)。比较两组不同时间点VAS分值、应激指标水平、分娩结局及新生儿情况。结果:试验组自然分娩为93.76%,高于常规组的64.52%(P<0.05);试验组用药后30 min、子宫口全开时及胎儿娩出时的视觉模拟评分法(VAS)评分分别为(1.56±0.44)、(1.63±0.24)、(1.84±0.57)分,均显著低于常规组的(1.85±0.54)、(2.11±0.65)分、(2.62±0.81)分(P<0.05);试验组胎儿娩出时的醛固酮(ALD)、去甲肾上腺素(NE)水平分别为(112.32±23.54)ng/L、(394.25±49.40)pg/ml,均显著低于常规组的(134.71±21.65)ng/L、(424.24±47.66)pg/ml(P<0.05);试验组新生儿出生后5 min Apgar评分为(8.97±0.68)分,与常规组的(8.94±0.63)分比较,差异无统计学意义(P>0.05)。结论:CEI模式和PIEB技术应用于分娩镇痛中对新生儿情况的影响一致,但PIEB技术可降低VAS分值,减轻疼痛,下调应激指标水平和改善分娩结局。Objective:To explore the application effect of programmed intermittent epidural boluses(PIEB)technique and CEI mode in labor analgesia.Method:According to the computer grouping method,63 pregnant women who gave birth from October 2018 to May 2020 in the Family Planning Service Center of Xingning Maternal and Child Health Hospital were divided into the routine group(n=31,CEI mode anesthesia in labor analgesia)and the experimental group(n=32,PIEB technical anesthesia for labor analgesia).The VAS scores,stress index levels at different time points,delivery outcomes and neonatal conditions were compared between the two groups.Result:The rate of natural delivery in the experimental group was 93.76%,which was higher than 64.52%in the routine group(P<0.05).The visual analogue scale(VAS)scores of the experimental group at 30 minutes after medication,time of uterine orifice fully open and time of fetal delivery were(1.56±0.44),(1.63±0.24)and(1.84±0.57)points,which were significantly lower than(1.85±0.54),(2.11±0.65),(2.62±0.81)points of the routine group(P<0.05);the levels of aldosterone(ALD)and norepinephrine(NE)in the experimental group at delivery were(112.32±23.54)ng/L and(394.25±49.40)pg/ml,respectively,were significantly lower than(134.71±21.65)ng/L and(424.24±47.66)pg/ml of the routine group(P<0.05).Apgar scores of the neonates at 5 minutes after birth was(8.97±0.68)points in the experimental group,which was not statistically significant compared with(8.94±0.63)points of the routine group(P>0.05).Conclusion:The application of CEI model and PIEB technology in labor analgesia has the same effect on newborns,but PIEB technology can reduce VAS score,relieve pain,lower the stress index level and improve the delivery outcome.

关 键 词：程控硬膜外间歇脉冲注入 持续硬膜外输注 应激指标 分娩镇痛 

分 类 号：R714.3[医药卫生—妇产科学]