分娩镇痛中意外硬脊膜穿破后连续蛛网膜下腔置管对产妇产后头痛的影响  

Effect of continuous subarachnoid catheterization on postpartum headache in parturient after accidental dural puncture during labor analgesia

作　　者：刘瑞合 赵志强 武军 江润竹 杨园园 LIU Ruihe;ZHAO Zhiqiang;WU Jun;JIANG Runzhu;YANG Yuanyuan(Department of Anesthesiology,Women and Children’s Health Care Hospital of Linyi,Shandong Province,Linyi 276300,China)

机构地区：[1]山东省临沂市妇幼保健院麻醉科,山东临沂276300

出　　处：《妇儿健康导刊》2022年第11期63-66,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的对意外硬脊膜穿破的产妇采取连续蛛网膜下腔置管进行分娩镇痛的方法,主要讨论该方法对产妇产后头痛的影响。方法选取2020年7月至2021年9月于临沂市妇幼保健院进行分娩的60例意外硬脊膜穿破的产妇为研究对象,在实施分娩镇痛时意外穿破硬脊膜后,按照处理方式不同分为观察组和对照组,每组各30例。观察组硬脊膜穿破后行连续蛛网膜下腔置管的方式进行分娩镇痛,对照组硬脊膜穿破后换间隙继续硬膜外置管的方式进行分娩镇痛,将产妇产后7 d内的硬脊膜穿破后头痛(PDPHA)发生率、疼痛的程度和时长及并发症发生率进行比较。结果产后7 d内两组产妇PDPHA发生率比较,差异无统计学意义(P>0.05);观察组产妇VAS评分低于对照组,且疼痛持续时长短于对照组,差异有统计学意义(P<0.05);两组产妇产后并发症发生率比较,差异无统计学意义(P>0.05)。结论在产妇分娩镇痛中意外穿破硬脊膜后采取连续蛛网膜下腔置管的方法,能够减轻产妇PDPHA的程度和时长,具有良好的安全性,值得临床推广使用。Objective To discuss the effect of continuous subarachnoid catheterization on postpartum headache for labor analgesia in parturients with accidental dural puncture.Methods A total of 60 parturient with accidental dural puncture who delivered in Women and Children’s Health Care Hospital of Linyi from July 2020 to September 2021 were selected as the research objects,after accidental dural puncture during labor analgesia,they were divided into observation group and control group according to different treatment methods,with 30 cases in each group.The observation group received labor analgesia by continuous subarachnoid catheterization after dural puncture,and the control group received labor analgesia by continuous epidural catheterization after dural puncture.The incidence of post-dural puncture headache(PDPHA),the degree and duration of pain and the incidence of complications within 7 days after delivery were compared.Results There was no significant difference in the incidence of PDPHA between the two groups within 7 days after delivery(P>0.05).The VAS score of the observation group was lower than that of the control group,and the duration of pain was shorter than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postpartum complications between the two groups(P>0.05).Conclusion Continuous subarachnoid catheterization after accidental dural puncture in parturient labor analgesia can reduce the degree and duration of postpartum PDPHA in parturient women,and has good safety,which is worthy of clinical application.

关 键 词：分娩镇痛 蛛网膜下腔置管 硬脊膜穿破后头痛 

分 类 号：R614.4[医药卫生—麻醉学]