[1]李 群.三种分娩镇痛法对产妇疼痛度、分娩方式及母婴结局的影响[J].医学信息,2024,37(15):111-114.[doi:10.3969/j.issn.1006-1959.2024.15.025]
　LI Qun.Effect of Three Labor Analgesia Methods on Maternal Pain, Delivery Mode and Maternal and Infant Outcomes[J].Journal of Medical Information,2024,37(15):111-114.[doi:10.3969/j.issn.1006-1959.2024.15.025]
点击复制

三种分娩镇痛法对产妇疼痛度、分娩方式及母婴结局的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年15期
页码:
111-114
栏目:
论著
出版日期:
2024-08-01

文章信息/Info

Title:
Effect of Three Labor Analgesia Methods on Maternal Pain, Delivery Mode and Maternal and Infant Outcomes
文章编号:
1006-1959（2024）15-0111-04
作者:
李 群
（遂川县中医院妇产科，江西 遂川 343900）
Author(s):
LI Qun
(Department of Obstetrics and Gynecology,Suichuan County Hospital of Traditional Chinese Medicine,Suichuan 343900,Jiangxi,China)
关键词:
导乐镇痛; 硬膜外镇痛; 分娩方式; 母婴结局
Keywords:
Doula analgesia; Epidural analgesia; Delivery mode; Maternal and infant outcomes
分类号:
R714
DOI:
10.3969/j.issn.1006-1959.2024.15.025
文献标志码:
A
摘要:
目的 研究三种分娩镇痛法对产妇疼痛度、分娩方式及母婴结局的影响。方法 选取2021年4月-2023年4月我院分娩的81例产妇为研究对象，随机分为硬膜外镇痛组、导乐镇痛组、经皮神经电刺激仪组，各组27例。比较三组镇痛疼痛评分（VAS）、产后2 h出血量、新生儿Apgar评分、产妇不同产程时间、分娩方式、产妇产后尿潴留发生率。结果 硬膜外镇痛组VAS评分均低于导乐镇痛组、经皮神经电刺激仪组，且经皮神经电刺激仪低于导乐镇痛组（P＜0.05），而三组产妇产后2 h出血量、新生儿Apgar评分比较，差异无统计学意义（P＞0.05）；硬膜外镇痛组、经皮神经电刺激仪组产妇第一、第二产程时间均短于导乐镇痛组（P＜0.05），但硬膜外镇痛组、经皮神经电刺激仪组比较，差异无统计学意义（P＞0.05），且三组产妇第三产程时间比较，差异无统计学意义（P＞0.05）；硬膜外镇痛组、经皮神经电刺激仪组产妇自然分娩均高于导乐镇痛组，中转剖宫产均低于导乐镇痛组（P＜0.05），而三组产钳助产率比较，差异无统计学意义（P＞0.05）；硬膜外镇痛组、经皮神经电刺激仪组产后尿潴留发生率均低于导乐镇痛组（P＜0.05），但硬膜外镇痛组、经皮神经电刺激仪组比较，差异无统计学意义（P＞0.05）。结论 与导乐镇痛比较，硬膜外镇痛与经皮神经电刺激仪镇痛效果相当，可缩短第一、第二产程时间，降低镇痛评分，提高自然分娩率，降低中转剖宫产率，且可预防产后尿潴留的发生。因此，硬膜外镇痛与经皮神经电刺激仪镇痛方式可在分娩镇痛中加以应用。
Abstract:
Objective To study the effects of three labor analgesia methods on maternal pain, delivery mode and maternal and infant outcomes.Methods A total of 81 parturients who gave birth in our hospital from April 2021 to April 2023 were randomly divided into epidural analgesia group, Doula analgesia group and transcutaneous electrical nerve stimulator group, with 27 parturients in each group. The analgesic pain score (VAS), postpartum 2 h bleeding volume, neonatal Apgar score, maternal different labor time, delivery mode and incidence of postpartum urinary retention were compared among the three groups.Results The VAS score of the epidural analgesia group was lower than that of the Doula analgesia group and the transcutaneous electrical nerve stimulator group, and the transcutaneous electrical nerve stimulator was lower than the Doula analgesia group (P<0.05), while there was no significant difference in the amount of bleeding at 2 hours after delivery and neonatal Apgar score among the three groups (P>0.05). The first and second stages of labor in the epidural analgesia group and the transcutaneous electrical nerve stimulator group were shorter than those in the Doula analgesia group (P<0.05), but there was no significant difference between the epidural analgesia group and the transcutaneous electrical nerve stimulator group (P>0.05), and there was no significant difference in the third stage of labor among the three groups (P>0.05). The natural delivery of parturients in epidural analgesia group and transcutaneous electrical nerve stimulator group was higher than that in Doula analgesia group, and the conversion to cesarean section was lower than that in Doula analgesia group (P<0.05), but there was no significant difference in the rate of forceps delivery among the three groups (P>0.05). The incidence of postpartum urinary retention in epidural analgesia group and transcutaneous electrical nerve stimulator group was lower than that in Doula analgesia group (P<0.05), but there was no significant difference between the epidural analgesia group and the transcutaneous electrical nerve stimulator group (P>0.05).Conclusion Compared with Doula analgesia, epidural analgesia has the same analgesic effect as transcutaneous electrical nerve stimulator. It can shorten the time of the first and second stages of labor, reduce the analgesia score, improve the natural delivery rate, reduce the rate of cesarean section, and prevent the occurrence of postpartum urinary retention. Therefore, epidural analgesia and transcutaneous electrical nerve stimulator analgesia can be applied in labor analgesia.

参考文献/References:

[1]杨薇霖.针对小剂量罗哌卡因复合舒芬太尼不同麻醉方式用于无痛分娩的临床镇痛效果比较研究[J].医学美学美容,2020,29(6):1-2．[2]陈耀兵,刘晶晶,孙星峰,等.纳布啡减少罗哌卡因用于硬膜外分娩镇痛的剂量:一项随机、双盲、对照研究[J].中国临床医学,2021,28(3):381-386.[3]Bos EME,Hollmann MW,Lirk P.Safety and efficacy of epidural analgesia[J].Curr Opin Anaesthesiol,2017,30(6):736-742．[4]赵丽斌,杨红艳,李长红,等.评估引导下不同穿刺技术对初产妇智能化病人自控镇痛分娩镇痛效应的影响[J].广东医学,2020,41(11):1134-1138．[5]韩小玲,叶庚秀,肖婷婷.全程陪伴结合分娩镇痛对自然分娩产妇疼痛程度及产程的影响[J].山西医药杂志,2020,49(14):1914-1916．[6]廖光东,罗东,姚强.美国妇产科医师学会“2017产科镇痛和麻醉实践指南”解读[J].实用妇产科杂志,2017,33(8):586-589.[7]李燕,朱桃花,李如霞,等.分娩镇痛在剖宫产后阴道试产中的应用效果[J].中国妇幼健康研究,2018,29(9):1167-1171.[8]刘旺生,王金鸿,黄欢.PCEA联合规律间断注入联合不同剂量罗哌卡因对产妇分娩 镇痛效果及母婴结局的影响[J].昆明医科大学学报,2019,40(7):41-46.[9]杨坤渹,李扬,易勤美.硬膜外阻滞分娩镇痛不同给药方式对产妇运动功能及分娩结局 的影响[J].湖南师范大学学报(医学版),2019,16(4):86-90．[10]晏明,孙剑,丁松,等.罗哌卡因复合纳布啡与罗哌卡因复合芬太尼用于硬膜外分娩镇痛的比较[J].国际麻醉学与复苏杂志,2020,41(5):475-478.[11]刘莉萍,宣荣荣,朱虹,等.硬膜外分娩镇痛对产妇炎症因子、补体及免疫功能的影响分析[J].中华全科医学,2019,17(2):241-244.[12]黄文雯,曲元.硬膜外分娩镇痛与分娩相关神经并发症[J].中华围产医学杂志,2019,22(2):93-96.[13]张晓兴,罗琼,李琼珊,等.分娩镇痛产妇第二产程时长对产后盆底功能影响的研究[J].浙江医学,2020,42(10):1048-1050.[14]陈健,陈清娟,郑丹,等.罗哌卡因复合舒芬太尼用于产妇自控硬膜外分娩镇痛的效果及对血浆催乳素的影响[J].中国性科学,2017,26(2):102-104.[15]张小平,尉文功.乐蓓尔分娩镇痛仪在产科患者中的临床疗效分析[J].解放军预防医学杂志,2019,37(3):179,186.[16]任晓娅,刘艳云,田亚菊,等.导乐分娩配合GT-4A导乐分娩镇痛仪在阴道分娩中的临床应用[J].海南医学,2015(6):825-827.[17]谢星,张丽芳.椎管内分娩镇痛对足月初产妇产程进展及分娩结局的影响[J].现代妇产科进展,2018,27(5):375-376,380.[18]欧琳霞,邓思梅,苏爱琳.硬膜外分娩镇痛对母婴结局及产妇血清PGE和SP表达的影响[J].中国妇幼保健,2021,36(4):949-951. [19]胡兢.纳布啡复合罗哌卡因腰硬联合麻醉对分娩镇痛患者血浆ACTH、Cor水平的影响[D].南昌:南昌大学,2023.

相似文献/References:

[1]刘同昊,李元海,鲁显福,等.食管癌根治术后发生胸腔积液的危险因素分析[J].医学信息,2023,36(22):68.[doi:10.3969/j.issn.1006-1959.2023.22.014]
　LIU Tong-hao,LI Yuan-hai,LU Xian-fu,et al.Analysis of Risk Factors for Pleural Effusion After Radical Resection of Esophageal Cancer[J].Journal of Medical Information,2023,36(15):68.[doi:10.3969/j.issn.1006-1959.2023.22.014]

更新日期/Last Update: 1900-01-01