程控硬膜外间歇脉冲注入技术对产妇分娩镇痛及分娩结局的影响

Effect of programmed intermittent epidural boluses technique on labor analgesia and delivery outcomes

目的观察程控硬膜外间歇脉冲注入(PIEB)技术对产妇分娩镇痛及分娩结局的影响。方法选择行硬膜外分娩镇痛的足月初产妇200例,其中100例行PIEB模式镇痛(A组),100例行持续硬膜外背景输注(CEI)模式镇痛(B组)。比较两组产妇分娩镇痛效果、产程、新生儿Apgar评分等相关指标。结果A组器械助产使用率和剖宫产率均低于B组(P<0.05)。与镇痛前比较,两组产妇镇痛后VAS疼痛评分降低(P<0.05)。A组镇痛期间宫缩VAS疼痛评分>3分比率低于B组(11%vs.43%)(P<0.05)。A组用药总量、追加自控镇痛次数及产程末期会阴胀痛率均低于B组(P<0.05)。A组产妇患者满意度高于B组(P<0.05)。两组产妇产后出血量及不良反应发生率比较无统计学差异(P>0.05)。两组新生儿Apgar评分比较差异无统计学意义(P>0.05)。结论与CEI模式相比,行PIEB技术行硬膜外分娩镇痛效果更好。

Objective To observe the effect of programmed intermittent epidural boluses(PIEB)technique on labor analgesia and delivery outcomes.Methods Epidural labor analgesia was used in 200 full-term parturients,which was performed with PIEB technique(group A,100 cases)or CEI model(group B,100 cases).The analgesic efficacy,delivery process,neonatal Apgar scores were compared between the two groups.Results The percentages of the parturients underwent assisted delivery and Cesarean section in group A were less than those in group B(P<0.05).Compared with before analgesia,the maternal VAS pain score of two groups decreased after analgesia(P<0.05).The percentage of the parturients with uterine contraction VAS pain score>3 points was less in group A than that in group B(11%vs.43%)(P<0.05).The total amount of anesthesia medication,the number of additional self-controlled analgesia,and the incidence of perineal pain at the end of labor were lower in group A than those in group B(P<0.05).The Apgar scores of newborns between two groups had no significant difference(P>0.05).The satisfaction of parturients in group A was better than that in group B(P<0.05).There were no significant differences in postpartum hemorrhage and adverse responses between the two groups(P>0.05).Conclusion For epidural labor analgesia,PIEB technique is better than CEI model.