腰硬联合阻滞麻醉在产妇分娩中的应用效果  

Application effects of combined spinal-epidural block anesthesia in maternal delivery

作　　者：肖远航 XIAO Yuanhang(Department of Anesthesiology of Women&Infants Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市妇幼保健院麻醉科,河南郑州450000

出　　处：《中国民康医学》2023年第22期77-79,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察腰硬联合阻滞麻醉在产妇分娩中的应用效果。方法:回顾性分析2022年2月至2023年2月该院收治的98例无痛分娩产妇的临床资料,按照麻醉方案不同将其分为观察组和对照组各49例。对照组实施硬膜外麻醉,观察组实施腰硬联合阻滞麻醉。比较两组镇痛效果(镇痛起效时间、镇痛维持时间)、产程时间(第一、第二、第三产程)、不同时间(镇痛后10、30、60 min)疼痛[视觉模拟评分法(VAS)]评分、分娩前后应激指标[皮质醇(Cor)、脂联素(ADI)]水平,以及母婴结局(自然分娩率、胎儿宫内窘迫发生率、新生儿Apgar评分)。结果:观察组镇痛起效时间短于对照组,镇痛维持时间长于对照组,差异有统计学意义(P<0.05);观察组第一、第二、第三产程均短于对照组,差异有统计学意义(P<0.05);镇痛后10、30、60 min,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);分娩后24 h,观察组Cor水平低于对照组,ADI水平高于对照组,差异有统计学意义(P<0.05);两组自然分娩率、胎儿宫内窘迫发生率和新生儿Apgar评分比较,差异均无统计学意义(P>0.05)。结论:腰硬联合阻滞麻醉应用于分娩产妇可缩短镇痛起效时间和产程时间,延长镇痛维持时间,降低VAS评分,改善应激指标水平,效果优于硬膜外麻醉。Objective:To observe application effects of combined spinal-epidural block anesthesia in maternal delivery.Methods:The clinical data of 98 parturients with painless delivery admitted to this hospital from February 2022 to February 2023 were retrospectively analyzed.According to different anesthesia schemes,they were divided into observation group and control group,49 cases in each group.The control group was given epidural anesthesia,while the observation group was given combined spinal-epidural anesthesia.The analgesic effect(onset time of analgesia,duration of analgesia),the labor time(first,second and third stages of labor),the pain[visual analogue scale(VAS)]scores at different time(10,30 and 60 min after analgesia),the stress indicator levels[cortisol(Cor),adiponectin(ADI)]before and after the delivery,and the maternal-infant outcomes(natural delivery rate,incidence of fetal distress,neonatal Apgar score)were compared between the two groups.Results:The onset time of analgesia in the observation group was shorter than that in the control group,the duration of analgesia was longer than that in the control group,and the differences were statistically significant(P<0.05).The first,second and third stages of labor in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).10,30 and 60 min after analgesia,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).24 h after the delivery,the level of Cor in the observation group was lower than that in the control group,the level of ADI was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there were no significant differences in the natural delivery rate,the incidence of fetal distress and the neonatal Apgar score between the two groups(P>0.05).Conclusions:The combined spinal-epidural block anesthesia for the parturients can shorten the onset time of analgesia

关 键 词：硬膜外麻醉 腰硬联合阻滞麻醉 分娩 镇痛 产程时间 应激指标 母婴结局 

分 类 号：R614[医药卫生—麻醉学]