NBASS-APS在高海拔地区自然分娩孕妇疼痛管理的应用研究  

Application of NBASS-APS in pain management of pregnant women undergoing natural childbirth in high-altitude areas

作　　者：侯喜龙[1] 孟丹[1] 王茉莉[1] 王伟华[1] 米玛 索朗欧珠 赵琳[3] 拉姆次仁 HOU Xilong;MENG Dan;WANG Moli;WANG Weihua;MI Ma;SUOLANG Ouzhu;ZHAO Lin;LAMU Ciren(The Department of Anesthesiology,the Second People’s Hospital of Dalian,Dalian,Liaoning 116011,China;The Department of Anesthesiology,Suoxian People’s Hospital,Naqu,Xizang 852200,China;Nursing Department of Dalian Municipal Central Hospital,Dalian,Liaoning 116021,China)

机构地区：[1]大连市第二人民医院麻醉科,辽宁大连116011 [2]索县人民医院麻醉科,西藏那曲852200 [3]大连市中心医院护理部,辽宁大连116021

出　　处：《中国优生与遗传杂志》2024年第10期2066-2071,共6页Chinese Journal of Birth Health & Heredity

基　　金：西藏自治区自然科学基金组团式医学援藏项目[XZ2023ZR-ZY86(Z)]。

摘　　要：目的分析以护士为基础,以麻醉医师和专科医师为指导的急性疼痛服务(NBASS-APS)在高海拔地区自然分娩孕妇疼痛管理的应用效果。方法选取索县人民医院2023年1月至2024年2月收治的188例高海拔地区自然分娩孕妇为研究对象,按照随机数字表法分为对照组(n=94)予以传统疼痛管理,观察组(n=94)予以NBASS-APS疼痛管理。检测对比两组产程时长、产程期间生命体征、分娩疼痛、会阴裂伤程度、新生儿脐动脉血血气及Apgar评分、生理恢复指标、分娩后心理状况、护理满意度。结果与对照组相比,观察组第一产程时间、第二产程时间、第三产程时间及总产程时间、首次下床时间、住院时间较短,SAS、SDS评分较低,分娩指导、自身分娩经历评分较高(P<0.05)。两组镇痛前、镇痛后、分娩后血氧饱和度、心率、收缩压、舒张压、镇痛前VAS评分、会阴Ⅰ度裂伤占比、Ⅳ度裂伤占比、pH值、PCO_(2)、PO_(2),以及1 min、5 min Apgar评分对比,差异无统计学意义(P>0.05)。与对照组相比,观察组镇痛后5 min、10 min、30 min、60 min、宫口开大7~8 cm时VAS评分较低,会阴Ⅱ度、Ⅲ度裂伤占比较低,无损伤占比较高(P<0.05)。结论高海拔地区自然分娩孕妇疼痛管理中应用NBASS-APS可减轻产妇分娩疼痛,缩短产程时长,且产妇会阴裂伤程度较轻,恢复较快,分娩后心理状态较佳。Objective To analyze the effect ofnurse based anesthesiologist and specialist supervised-acute pain service(NBASS-APS)guided by anesthesiologists and specialists in pain management of pregnant women with natural delivery at high altitude.Methods 188 pregnant women with natural childbirth in high-altitude areas admitted to Suoxian People’s Hospital from January 2023 to February 2024 were selected as the research subjects.They were randomly divided into a control group(n=94)receiving traditional pain management and an observation group(n=94)receiving NBASS-APS pain management using a random number table method.Compare the duration of labor,vital signs during labor,delivery pain,degree of perineal laceration,umbilical artery blood gas and Apgar score,physiological recovery indicators,psychological status after delivery,and nursing satisfaction between two groups.Results Compared with the control group,the observation group had shorter first,second,third,total labor process time,first time out of bed,and length of hospital stay,lower SAS and SDS scores,and higher scores for delivery guidance and self delivery experience(P<0.05).Comparison of blood oxygen saturation,heart rate,systolic blood pressure,diastolic blood pressure,VAS scores before analgesia,proportion of perineal gradeⅠandⅣlacerations,pH value,PCO2,PO2,and 1-minute and 5-minute Apgar scores between two groups(P>0.05).Compared with the control group,the VAS score of the observation group was lower at 5 minutes,10 minutes,30 minutes,and 60 minutes after analgesia,and at 7-8 cm of uterine opening.The proportion of perineal second and third degree lacerations was lower,and the proportion of no damage is relatively high(P<0.05).Conclusion The application of NBASS-APS in pain management for natural childbirth pregnant women in high-altitude areas can alleviate childbirth pain,shorten the duration of labor,and alleviate perineal lacerations,resulting in faster recovery and better psychological state after delivery.

关 键 词：以护士为基础 以麻醉医师和专科医师为指导的急性疼痛服务 高海拔地区 自然分娩 疼痛管理 产程时长 

分 类 号：R714.3[医药卫生—妇产科学]