不同分娩镇痛时间椎管内阻滞麻醉在产妇中的应用效果  

Application Effect of Intraspinal Block Anesthesia with Different Labor Analgesia Time in Parturients

作　　者：李金志 吴丹[1] 谢惠娟[1] 李捷萌[1] LI Jinzhi;WU Dan;XIE Huijuan;LI Jiemeng(Quanzhou Hospital of Traditional Chinese Medicine,Quanzhou 362000,China;不详)

机构地区：[1]泉州市中医院,福建泉州362000

出　　处：《中外医学研究》2023年第18期26-30,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不同分娩镇痛时间椎管内阻滞麻醉在产妇中的应用效果。方法:选取2020年3月—2021年3月泉州市中医院收治的114例即将分娩的孕妇,随机数表法将其分成两组,各57例。对照组活跃期行椎管内阻滞麻醉镇痛,试验组潜伏期行椎管内阻滞麻醉镇痛。比较两组产妇剖宫产率、顺产新生儿1 min Apgar评分,第一、二产程时间,注药后不同时间视觉模拟评分法(VAS)评分及新生儿脐动脉血气分析指标及产后盆底功能情况。结果:对照组剖宫产率为22.81%,显著高于试验组的8.77%,差异有统计学意义(P<0.05);试验组顺产新生儿1 min Apgar评分高于对照组,差异有统计学意义(P<0.05)。试验组产妇第一、二产程时间均明显短于对照组,差异有统计学意义(P<0.05)。试验组产妇注药后1 min、5 min的VAS评分均显著低于对照组,差异有统计学意义(P<0.05);两组产妇注药后15 min、30 min、60 min的VAS评分,差异无统计学意义(P>0.05)。试验组新生儿脐动脉二氧化碳分压(PaCO_(2))显著优于对照组,差异有统计学意义(P<0.05);两组新生儿脐动脉p H值、碱剩余(BE)及血红蛋白(Hb)比较,差异无统计学意义(P>0.05)。试验组产妇产后1个月膀胱颈移动度(BND)、最大Valsalva状态膀胱尿道后角及Max-Valsalva肛提肌裂孔面积均显著低于对照组,差异有统计学意义(P<0.05);两组产妇产后3个月盆底功能比较,差异无统计学意义(P>0.05)。结论:产妇分娩潜伏期进行椎管内阻滞麻醉能缩短产程时间、缓解分娩疼痛,改善母婴结局,降低对盆底功能的损伤。Objective:To investigate the application effect of intraspinal block anesthesia with different labor analgesia time in parturients.Method:A total of 114 pregnant women who were about to give birth admitted to Quanzhou Hospital of Traditional Chinese Medicine from March 2020 to March 2021 were selected,and they were randomly divided into two groups according to the random number table method,57 cases in each group.The control group was given intraspinal block anesthesia and analgesia during the active period,and the experimental group was given intraspinal block anesthesia and analgesia during the incubation period.The cesarean section rate,1 min Apgar score of normal neonates,the time of first and second stage of labor,visual analogue scale(VAS)scores at different time after injection,neonatal umbilical artery blood gas analysis indexes and postpartum pelvic floor function were compared between two groups.Result:The cesarean section rate of the control group was 22.81%,which was significantly higher than 8.77%of the experimental group,and the difference was statistically significant(P<0.05).The 1 min Apgar score of normal neonates in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).The first and second stage of labor in the experimental group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).The VAS scores of 1 min and 5 min after injection in the experimental group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05);there were no significant differences in VAS scores between two groups at 15 min,30 min and 60 min after injection(P>0.05).The partial pressure of carbon dioxide(PaCO_(2))of umbilical artery in the experimental group was significantly better than that in the control group(P<0.05);there were no significant differences in umbilical artery pH,base excess(BE)and hemoglobin(Hb)between two groups(P>0.05).

关 键 词：分娩镇痛 椎管内阻滞麻醉 盆底超声 剖宫产率 

分 类 号：R714.3[医药卫生—妇产科学]