硬脊膜穿破硬膜外阻滞联合PIEB技术用于产妇分娩镇痛的临床效果  

Clinical Effect of Dural Puncture Epidural Combined with PIEB Technique for Labor Analgesia in Parturients

作　　者：单会荣 陈敏敏 谢港文 SHAN Huirong;CHEN Minmin;XIE Gangwen(Department of Anesthesiology,Gao’an Maternal and Child Health Hospital,Gao’an 330800,China;不详)

机构地区：[1]高安市妇幼保健院麻醉科,江西高安330800

出　　处：《中国医学创新》2025年第12期127-130,共4页Medical Innovation of China

摘　　要：目的:探讨产妇分娩中采用硬脊膜穿破硬膜外阻滞联合程控硬膜外间歇脉冲注入(PIEB)技术的镇痛效果。方法:按随机数字表法将2022年4月—2024年4月于高安市妇幼保健院行分娩镇痛的98例产妇分为两组,各49例。对照组采用硬膜外阻滞联合PIEB,观察组采用硬脊膜穿破硬膜外阻滞联合PIEB。比较两组镇痛效果、镇痛起效时间,以及暴发痛、骶尾部阻滞不全、分娩方式、新生儿窒息及不良反应发生情况。结果:观察组镇痛起效时间短于对照组,T_(1)时视觉模拟评分法(VAS)评分低于对照组,差异均有统计学意义(P<0.05)。观察组暴发痛与骶尾部阻滞不全发生率均低于对照组,差异均有统计学意义(P<0.05)。两组阴道分娩、剖宫产、器械助产、新生儿窒息发生率及不良反应总发生率比较,差异均无统计学意义(P>0.05)。结论:产妇采用硬脊膜穿破硬膜外阻滞联合PIEB分娩镇痛,起效快速且镇痛效果良好,可降低暴发痛与骶尾部阻滞不全发生率,且对产妇和新生儿无明显不良影响。Objective:To investigate the analgesic effect of dural puncture epidural combined with programmed intermittent epidural bolus(PIEB)during delivery in parturients.Method:A total of 98 parturients who received labor analgesia in Gao’an Maternal and Child Health Hospital from April 2022 to April 2024 were divided into two groups according to random number table method,with 49 cases in each group.The control group received epidural block combined with PIEB,and the observation group received dural puncture epidural combined with PIEB.The analgesic effect,onset time of analgesia and the incidence of breakthrough pain,sacrococcygeal block insufficiency,delivery mode,neonatal asphyxia and adverse reactions were compared between the two groups.Result:The onset time of analgesia in the observation group was shorter than that in the control group,and the visual analogue scale(VAS)score at T_(1)was lower than that in the control group,the differences were statistically significant(P<0.05).The incidences of breakthrough pain and sacrococcygeal block insufficiency in observation group were lower than those in control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidences of vaginal delivery,cesarean section,assisted apparatus delivery,neonatal asphyxia and the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dural puncture epidural combined with PIEB for parturients labor analgesia has rapid onset and good analgesic effect,which can reduce the incidence of breakthrough pain and sacrococcygeal block insufficiency,and has no obvious adverse effects on parturients and neonates.

关 键 词：产妇 分娩镇痛 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 镇痛起效时间 不良反应 

分 类 号：R714.3[医药卫生—妇产科学]