摘要
目的 探讨程控硬膜外间歇脉冲注入(PIEB)与连续硬膜外输注(CEI)在产妇分娩镇痛中的效果及对新生儿血气指标的影响.方法 回顾性分析2019年6月至2020年12月在浙江省台州医院行无痛分娩的108例产妇的临床资料,根据不同的镇痛模式将其分为对照组(54例)和观察组(54例).对照组给予CEI模式镇痛,观察组实施PIEB模式镇痛.比较2组产妇不同时间点疼痛程度[视觉模拟评分法(VAS)评分]、应激指标[醛固酮(ALD)、去甲肾上腺素(NE)]、产程时间以及新生儿血气指标[pH值、氧分压(PO2)、二氧化碳分压(PCO2)、血乳酸(LAC)].结果 观察组在T1、T2、T3时间点VAS评分均低于对照组(P＜0.05);在胎儿娩出时,观察组ALD、NE水平均低于对照组(P＜0.05);观察组第一产程、第二产程、第三产程和总产程时间均低于对照组(P＜0.05);2组新生儿pH值、PO2、PCO2以及LAC水平比较差异无统计学意义(P＞0.05).结论 PIEB镇痛模式应用于产妇分娩镇痛可有效降低疼痛程度以及应激指标水平,同时还可缩短产程,且对新生儿无影响,值得临床推广应用.
Abstract
Objective To explore the effect of programmed intermittent epidural bolus(PIEB)and contin-uous epidural infusion(CEI)in maternal labor analgesia and its effect on neonatal blood gas indicators.Methods A retrospective analysis was conducted on the clinical data of 108 parturients who underwent painless delivery at Taizhou Hospital in Zhejiang from June 2019 to December 2020.They were divided into a control group(54 cas-es)and an observation group based(54 cases)according to different analgesic modes.The control group received CEI mode analgesia,while the observation group received PIEB mode analgesia.The pain levels[visual analog scale(VAS)],stress indicators[aldosterone(ALD),norepinephrine(NE)],labor process time,and neonatal blood gas parameters[pH,partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),and blood lactate(LAC)]were compared at different time points for the two groups.Results The VAS scores in the observation group were significantly lower than those in the control group at time points T1,T2,and T3(P＜0.05).At the time of fetal delivery,the levels of ALD and NE in the observation group were significantly lower than those in the con-trol group(P＜0.05).The first stage,second stage,third stage,and total duration of labor in the observation group were all significantly shorter compared to the control group(P＜0.05).There were no statistically significant differ-ences in neonatal pH,PO2,PCO2,and LAC levels between the two groups(P＞0.05).Conclusion The applica-tion of PIEB analgesia mode in postpartum analgesia can more effectively reduce the degree of pain and stress in-dicators,while also shortening the delivery process without any adverse effects on newborns,which is worthy of clinical application.
维普
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