经皮穴位电刺激对硬膜外分娩镇痛产妇产时发热的影响  

Effect of transcutaneous electrical acupoint stimulation on maternal fever in puerpera undergoing epidural labor analgesia

作　　者：曹家刚 张丽峰 王一飞 李胜华[1] 罗威[1] 王长社[1] CAO Jiagang;ZHANG Lifeng;WANG Yifei;LI Shenghua;LUO Wei;WANG Changshe(Department of Anesthesiology,Shanghai Jiading District Maternal and Child Health Care Hospital,Shanghai 201800,China)

机构地区：[1]上海市嘉定区妇幼保健院麻醉科,201800 [2]上海市嘉定区中心医院内科

出　　处：《临床麻醉学杂志》2025年第1期36-39,共4页Journal of Clinical Anesthesiology

基　　金：嘉定区卫生健康委员会中医药科研立项项目(2021-KY-ZYY-006)。

摘　　要：目的观察经皮穴位电刺激(TEAS)合谷穴、足三里穴、三阴交穴对硬膜外分娩镇痛产妇产时发热的影响。方法选择行硬膜外分娩镇痛的初产妇136例,年龄20~40岁,BMI 20~35 kg/m^(2),ASAⅡ或Ⅲ级。采用随机数字表法将产妇分为两组:TEAS组(n=69)和对照组(n=67)。硬膜外分娩镇痛5 min后,TEAS组使用韩式电刺激仪刺激双侧合谷穴、足三里穴、三阴交穴,每小时施行一次,每次30 min,至分娩结束;对照组仅将电极放置于相应穴位不予电刺激。记录分娩镇痛前、镇痛后2、4 h、分娩即刻的鼓膜温度,并计算产时发热(≥37.5℃视为发热)率。记录分娩镇痛前、分娩即刻及分娩后1 h血清白细胞介素-6(IL-6)浓度。记录局麻药总用量、第一产程时间、第二产程时间。结果与分娩镇痛前比较,镇痛后4 h、分娩即刻两组产妇鼓膜温度明显升高(P<0.05),分娩即刻及分娩后1 h两组产妇血清IL-6浓度明显升高(P<0.05)。与对照组比较,TEAS组在分娩即刻与分娩后1 h血清IL-6浓度明显降低(P<0.05),局麻药总用量明显降低(P<0.05)。两组第一产程时间、第二产程时间差异无统计学意义。结论经皮穴位电刺激合谷穴、足三里穴、三阴交穴能够降低分娩镇痛产妇局麻药物用量,降低产妇血清IL-6浓度,减少产时发热率。Objective To observe the effect of transcutaneons electrical acupoint stimulation(TEAS)at Hegu,Zusanli,and Sanyinjiao on maternal fever in puerpera undergoing epidural labor analgesia.Methods A total of 136 primiparas undergoing epidural labor analgesia were selected,aged 20-40 years,BMI 20-35 kg/m^(2),ASA physical status Ⅱ or Ⅲ.According to the random number table method,the primiparas were divided into two groups:TEAS group(n=69)and control group(n=67).Five minutes after epidural labor analgesia,the TEAS group was given TEAS electrical stimulation at Hegu,Zusanli,and Sanyinjiao once an hour,for 30 minutes each time till the end of childbirth.In the control group,TEAS electrodes were attached to the same acupoints,but without electrical stimulation.Maternal tympanic temperature was measured before labor analgesia,2 hours after labor analgesia,4 hours after labor analgesia,and immediate delivery,and maternal fever(≥37.5℃)rate were evaluated.The serum levels of interleukin-6(IL-6)before labor analgesia,immediate delivery,and 1 hour after delivery was recorded.Labor analgesic consumption,the first stage of labor,the second stage of labor were recorded.Results Compared with before analgesia,maternal tympanic temperature was significantly increased 4 hours after analgesia and immediate delivery in both groups(P<0.05),and the level of IL-6 was significantly increased immediate delivery and 1 hour after delivery(P<0.05).Compared with the control group,the level of IL-6 was significantly decreased immediate delivery and 1 hour after delivery in the TEAS group(P<0.05),and the labor analgesic consumption was significantly decreased in the TEAS group(P<0.05).There were no significantly differences in the time of first stage of labor and the second stage of labor between the two groups.Conclusion TEAS at Hegu,Zusanli and Sanyinjiao can reduce the amount of anesthetics,and decrease the level of IL-6 and the incidence of fever during labor analgesia in the puerpera.

关 键 词：经皮穴位电刺激 硬膜外分娩镇痛 产时发热 

分 类 号：R71[医药卫生—妇产科学]