硬膜外程控间歇脉冲式分娩镇痛用于足月初产妇对产程、产间发热及母婴安全的影响  

Effects of Programmed Intermittent Epidural Bolus Used in Labor Analgesia for Full-Term Primiparas on Labor Process,Intrapartum Fever and Maternal and Infant Safety

作　　者：石松 鲍建中 张霞 赵英杰 许凤云 张爱荣 王月新 SHI Song;BAO Jian-zhong;ZHANG Xia;ZHAO Ying-jie;XU Feng-yun;ZHANG Ai-rong;WANG Yue-xin(Department of Anesthesiology,Affiliated Hospital of Hebei University,Baoding,Heibei,071030,China;Department of Anesthesiology,Cangzhou People's Hospital,Cangzhou,Heibei,061000,China;Department of Gynecology,Yihe Hospital,Cangzhou People's Hospital,Cangzhou,Heibei,061000,China;Obstetrical Operation Room,Yihe Hospital,Cangzhou People's Hospital,Cangzhou,Heibei,061000,China)

机构地区：[1]河北大学附属医院麻醉科,河北保定071030 [2]沧州市人民医院麻醉科,河北沧州061000 [3]沧州市人民医院颐和院区妇科,河北沧州061000 [4]沧州市人民医院颐和院区产科手术室,河北沧州061000

出　　处：《现代生物医学进展》2024年第19期3755-3757,共3页Progress in Modern Biomedicine

基　　金：河北省2022年度医学科学研究课题计划项目(20220321)。

摘　　要：目的:探究硬膜外程控间歇脉冲式分娩镇痛用于足月初产妇对产程、产间发热及母婴安全的影响。方法:选取2019年1月-2024年1月于医院分娩的102例足月初产妇作为研究对象,根据镇痛方式的不同分为两组,其中CEI组(n=52)采用连续硬膜外输注,PIEB组(n=50)采用硬膜外程控间歇脉冲注射,比较两组分娩情况、疼痛程度、产间发热情况、母婴安全以及不良反应发生情况。结果:两组第一产程及第三产程持续时间比较未见显著差异(P>0.05);PIEB组第二产程持续时间短于CEI组,自控阵痛泵(PCA)按压次数以及镇痛药物用量均少于CEI组(P<0.05);两组T0~T1时的视觉模拟评分(VAS)比较未见统计学差异(P>0.05);PIEB组T2~T4时的VAS显著低于CEI组(P<0.05);两组T0~T2时的鼓膜温度比较未见统计学差异(P>0.05);PIEB组T3、T4时的鼓膜温度显著低于CEI组(P<0.05);PIEB组产检发热率10.00%低于CEI组的26.92%(P<0.05);两组婴儿1 min、5 min Apgar评分以及产妇产后出血率比较未见统计学差异(P>0.05)。结论:与连续硬膜外输注相比,足月初产妇分娩镇痛中采用硬膜外程控间歇脉冲式注射可缩短第二产程以及减少PCA按压次数以及镇痛药物剂量,且不增加孕妇产间发热情况,具有较高安全性,值得临床推广。Objective:To explore the effects of programmed intermittent epidural bolus(PIEB)used in labor analgesia for full-term primiparas on labor process,intrapartum fever and maternal and infant safety.Methods:102 full-term primiparas who gave birth in the hospital from January 2019 to January 2024 were selected as the study subjects.According to different analgesic methods,they were assigned to continuous epidural infusion(CEI)group(n=52,CEI)and PIEB group(n=50,PIEB).The delivery situation,pain degree,intrapartum fever,maternal and infant safety,and the incidence rates of adverse reactions were compared between groups.Results:As for the duration of the first and third stages of labor,there was no significant difference between groups(P>0.05).Compared to CEI group,the duration of the second stage of labor was shorter,and the pressing times of patient-controlled analgesia(PCA)pump and the dosage of analgesics were lower in PIEB group(P<0.05).The two groups had comparable Visual Analogue Scale(VAS)scores from T0 to T1(P>0.05).Compared to CEI group,PIEB group had lower VAS scores from T2 to T4(P<0.05).There was no statistically significant difference in tympanic temperature between the two groups from T0 to T2(P>0.05).At T3 and T4,PIEB group had lower tympanic temperature compared to CEI group(P<0.05).The incidence of intrapartum fever in PIEB group was 10.00%,lower than 26.92%in CEI group(P<0.05).1-minute and 5-minute neonatal Apgar scores and postpartum hemorrhage rates in the two groups were close(P>0.05).Conclusion:Compared to labor analgesia via CEI,labor analgesia via PIEB can shorten the second stage of labor of full-term primiparas,and reduce the pressing times of PCA pump and the dosage of analgesics,without increasing the incidence of intrapartum fever.

关 键 词：初产妇 硬膜外程控间歇脉冲式 产程 产间发热 母婴安全 

分 类 号：R614[医药卫生—麻醉学] R473.71[医药卫生—外科学]