[1]刘 杰,陈文美,冯 成,等.程控硬膜外间歇脉冲注入技术分娩镇痛对分娩结局的影响观察*[J].陕西医学杂志,2019,(3):304-306，310.
　LIU Jie,CHEN Wenmei,FENG Cheng,et al.Effects of parturition analgesia on the outcome of labor by programmedepidural intermittent pulse injection technique[J].,2019,(3):304-306，310.
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程控硬膜外间歇脉冲注入技术分娩镇痛对分娩结局的影响观察*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年3期
页码:
304-306，310
栏目:
基础研究
出版日期:
2019-03-05

文章信息/Info

Title:
Effects of parturition analgesia on the outcome of labor by programmedepidural intermittent pulse injection technique
文章编号:
DOI:10.3969/j.issn.10007377.2019.03.006
作者:
刘 杰; 陈文美; 冯 成; 朱 涛; 方 育
上海市松江区中心医院麻醉科（上海 201600）
Author(s):
LIU Jie; CHEN Wenmei; FENG Cheng; et al.
Department of Anesthesiology in Central Hospital of Shanghai Songjiang District（Shanghai 201600）
关键词:
程控硬膜外间歇脉冲注入技术; 硬膜外阻滞; 分娩镇痛; 分娩结局; 腹部手术; 影响
Keywords:
Key words Programmed epidural intermittent pulse injection; Epidural block; Labor anlgesia; Outcome of labor; Abdominal surgery; Inflences
分类号:
R614.4
文献标志码:
A
摘要:
摘 要 目的：观察程控硬膜外间歇脉冲注入（PIEB）技术分娩镇痛对分娩结局的影响。方法：采用前瞻性研究，选择拟分娩镇痛的初产妇246例，经产妇或家属知情同意后随机分为两组，均使用罗哌卡因、舒芬太尼镇痛，其中采用PIEB技术的123例为PIEB组，采用常规连续硬膜外（CEA）输注镇痛的123例为CEA组，从镇痛即刻开始，采用视觉模拟评分法（VAS）于分娩镇痛前、用药后2 h和宫口开全时评价疼痛程度，观察并分析用药总量、PCA次数、分娩方式、产后出血、胎儿窘迫及新生儿1 min、5 min Apgar评分。结果：PIEB组T1 、T2 VAS评分明显低于CEI组，PCA次数明显少于CEA组，罗哌卡因和舒芬太尼用量明显少于CEA组，差异均有统计学意义（P＜0.05）。PIEB组顺产、产钳助产、剖宫产率分别为82.93%、8.94%、8.13%，CEA组分别为81.30%、9.76%、8.94%，差异无统计学意义(P＞0.05)。PIEB组产后出血、胎儿窘迫发生率为3.25%、2.44%，CEA组为4.07%、3.25%，差异无统计学意义(P＞0.05)。两组新生儿1 min、5 min Apgar评分差异无统计学意义(P＞0.05)。结论：PIEB技术分娩镇痛与连续硬膜外输注分娩镇痛分娩结局相同，但PIEB技术可减少麻醉药物用量，提高镇痛效果。
Abstract:
Abstract Objective: To observe the effects of parturition analgesia by programmed epidural intermittent pulse injection (PIEB) on the outcome of labor. Methods: Adopt prospective study, choose labor analgesia of primipara 246 cases as the research object, through the maternal or families were randomly divided into two groups after informed consent, use ROM pp paid, sufentanil analgesia, with 123 cases using PIEB technology for PIEB group, the conventional continuous epidural infusion analgesia (CEA) in 123 cases for the CEA group, from analgesia begins immediately, by using visual analogue scale (VAS) before and after 2 h in labor analgesia palace mouth open fulltime evaluation of the degree of pain, The total dosage, number of PCA, mode of delivery, postpartum bleeding, fetal distress and neonatal 1 min and 5 min apgar score were recorded. Results: T1, T2 PIEB group, VAS score was lower than that in group CEI, PCA significantly less than the CEA group, luo pp paid and ShuFen, the dosage is obviously less than the CEA group, differences were statistically significant (P＜0.05). The rates of spontaneous.delivery, forceps delivery and cesarean section delivery in PIEB group were 82.93%, 8.94% and 8.13% respectively, while those in CEA group were 81.30%, 9.76% and 8.94% respectively, and the difference was not statistically significant (P＞0.05). The incidence of postpartum hemorrhage and fetal distress in PIEB group were 3.25% and 2.44%, while those in CEA group was 4.07% and 3.25%, with no statistically significant difference (P＞0.05). There was no significant difference in the scores of 1 min and 5 min apgar between the two groups (P＞0.05). Conclusion: PIEB technology can reduce the dosage of narcotic drugs and improve the analgesic effect.

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备注/Memo

备注/Memo:
*国家自然科学基金资助项目 （81660456）
更新日期/Last Update: 2019-03-15