硬膜外分娩镇痛冲击量给药联合以改良腰麻侧卧位为主的待产体位应用于妊娠期糖尿病产妇的效果  

Effect of Epidural Labor Analgesia Combined with Improved Position of Lying in Position on the Pregnant Women with Gestational Diabetes Mellitus

作　　者：雷燕霞 贺艳兰 肖燕[1] LEI Yanxia;HE Yanlan;XIAO Yan(Shenzhen Nanshan Maternal and Child Health Hospital,Shenzhen,Guangdong 518067)

机构地区：[1]深圳市南山区妇幼保健院,广东深圳518067

出　　处：《智慧健康》2022年第31期101-104,共4页Smart Healthcare

基　　金：深圳市南山区技术研发和创新设计项目《Syncytin-2在妊娠期糖尿病患者外周血及胎盘组织中的表达及其意义》(项目编号:2019013)。

摘　　要：目的研究硬膜外分娩镇痛冲击量给药联合以改良腰麻侧卧位为主的待产体位对妊娠期糖尿病产妇的影响。方法按照随机数字表法将本院2020年7月-2021年6月收治的120例妊娠期糖尿病产妇分为对照组和观察组,各为60例,对照组采用硬膜外分娩镇痛冲击量给药联合传统卧位,观察组采用硬膜外分娩镇痛冲击量给药联合以改良腰麻侧卧位为主的待产体位。观察两组产程时间、血糖水平、新生儿情况以及分娩结局。结果观察组潜伏期(6.49±1.38)h、活跃期(3.14±0.68)h、第二产程(0.91±0.13)h、第三产程时间(0.75±0.08)h均短于对照组(7.21±1.41)h、(3.52±0.69)h、(1.03±0.12)h、(0.83±0.21)h(P<0.05);观察组潜伏期(6.19±0.51)mmol/L、活跃期(6.67±0.45)mmol/L、第二产程血糖(6.79±0.26)mmol/L均低于对照组(6.39±0.47)mmol/L、(7.02±0.46)mmol/L、(7.09±0.72)mmol/L(P<0.05);观察组Apgar评分Ⅰ级、Ⅱ级、Ⅲ级的分布情况优于对照组(P<0.05);观察组自然分娩率(86.67%)高于对照组(61.67%),剖宫产率(8.33%)、手术助产率(21.67%)均低于对照组(5.00%)、(16.66%)(P<0.05)。结论将硬膜外分娩镇痛冲击量给药联合以改良腰麻侧卧位为主的待产体位应用于妊娠期糖尿病产妇中,可通过降低其血糖水平,缩短产程时间,增加自然分娩率,从而减少新生儿窒息的发生。Objective To study the effect of epidural labor analgesia combined with improved position of lying in position on the pregnant women with gestational diabetes mellitus.Methods According to the random number table method,120 cases of gestational diabetes in our hospital from July 2020 to June 2021 were divided into the control group and the observation group,60 cases in each group.The control group was given epidural labor analgesia and combined with traditional lying position.The observation group was given epidural labor analgesia and combined with improved lateral position.The duration of labor,blood glucose level,neonatal condition and delivery outcome were observed.Results The incubation period(6.49±1.38)h,active period(3.14±0.68)h,the second stage of labor(0.91±0.13)H and the third stage of labor(0.75±0.08)h in the observation group were shorter than those in the control group(7.21±1.41)h,(3.52±0.69)h,(1.03±0.12)h and(0.83±0.21)h(P<0.05);The latent period(6.19±0.51)mmol/L,active period(6.67±0.45)mmol/L and blood glucose in the second stage of labor(6.79±0.26)mmol/L in the observation group were lower than those in the control group(6.39±0.47)mmol/L,(7.02±0.46)mmol/L and(7.09±0.72)mmol/L(P<0.05);The distribution of Apgar scores I,ⅡandⅢin the observation group was better than that in the control group(P<0.05);The natural delivery rate(86.67%)in the observation group was higher than that in the control group(61.67%),the cesarean section rate(8.33%)and surgical midwifery rate(21.67%)were lower than those in the control group(5.00%)and(16.66%)(P<0.05).Conclusion The application of epidural labor analgesia combined with improved position of lying in position for pregnant women with gestational diabetes mellitus can reduce the blood glucose level,shorten the duration of labor and increase the rate of spontaneous delivery,thereby reducing the incidence of neonatal asphyxia.

关 键 词：分娩镇痛 改良腰麻侧卧位 妊娠期糖尿病 冲击量给药 

分 类 号：R714.256[医药卫生—妇产科学]