硬脊膜穿破硬膜外阻滞技术在妊娠期高血压疾病初产妇中的应用价值  

Application value of epidural block technique with dural puncture in primipara with hypertensive diseases during pregnancy

作　　者：李凤梅 丰常申 Li Fengmei;Feng Changshen(Department of Anesthesiology,Maternal and Child Health and Family Planning Service Center,Donggang District,Rizhao Shandong,276800,China;Department of Surgery,Maternal and Child Health and Family Planning Service Center,Donggang District,Rizhao Shandong,276800,China)

机构地区：[1]日照市东港区妇幼保健计划生育服务中心麻醉科,山东日照276800 [2]日照市东港区妇幼保健计划生育服务中心外科,山东日照276800

出　　处：《中外女性健康研究》2024年第8期1-3,51,共4页Women＇s Health Research

摘　　要：目的:研究硬脊膜穿破硬膜外阻滞(DPE)技术在妊娠期高血压疾病(PIH)初产妇中的应用价值。方法:选取2022年1月至2023年12月本院收治的96例PIH初产妇,按产妇保健手册编号尾号单双号分为两组,每组48例,对照组接受常规硬膜外阻滞(EPL)联合程控硬膜外间歇脉冲注入(PIEB)技术镇痛,研究组接受DPE联合PIEB镇痛,比较两组围术期指标、镇痛情况、应激因子水平及并发症。结果:研究组镇痛起效时间早于对照组,罗哌卡因总用量低于对照组(P<0.05);研究组用药后5min(T1)、10min(T2)、20min(T3)、30min(T4)、60min(T5)、宫口全开(T6)、分娩时(T7)的VAS分值均低于对照组(P<0.05);研究组T1~T7血氧饱和度(SpO_(2))均高于对照组,T4~T7平均脉动压(MAP)均低于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05)。结论:DPE可缩短PIH初产妇镇痛起效时间,降低镇痛药物使用量,减轻应激反应,且安全性高,值得应用。Objective:To study the application value of DPE technique in parturient women with pregnancy-induced hypertensive disease(PIH).Methods:96 cases of PIH primiparas admitted to our hospital from January 2022 to December 2023 were divided into two groups according to the number of maternal health manual,with 48 cases in each group,the control group received conventional epidural block(EPL)combined with programmed epidural intermittent pulse injection(PIEB)for analgesia,and the study group received DPE combined with PIEB analgesia.The perioperative indexes,analgesia,stress factor levels and complications were compared between the two groups.Results:The onset time of analgesia in the study group was earlier than that in the control group,and the total dosage of ropivacaine was lower than that in the control group(P<0.05).The study group received 5min(T1),10min(T2),the VAS scores of 20min(T3),30min(T4),60min(T5),full opening of the uterine orifice(T6)and delivery(T7)were lower than those of the control group(P<0.05);the blood oxygen saturation(SpO_(2))from T1 to T7 in the study group was higher than that in the control group,and the average pulse pressure(MAP)from T4 to T7 was lower than that in the control group(P<0.05);the incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion:DPE can shorten the onset time of PIH analgesia,reduce the amount of analgesic drugs,relieve stress reaction,and has high safety,which is worth promoting.

关 键 词：妊娠期高血压疾病 初产妇 硬脊膜穿破硬膜外阻滞 程控硬膜外间歇脉冲注入 硬膜外阻滞 

分 类 号：R614[医药卫生—麻醉学]