智能化自控镇痛泵对初产妇分娩镇痛效果、妊娠结局及泌乳功能的影响

Effect of intelligent self-controlled analgesic pump on labor analgesic effect,pregnancy outcome and lactation function of primipara

目的探讨智能化自控镇痛泵对初产妇分娩镇痛效果、妊娠结局及泌乳功能的影响。方法将2021年4月至2022年8月在河北省衡水市妇幼保健院产科行无痛分娩的220例初产妇用随机数字表法分为两组,均实施硬膜外麻醉,对照组采取常规镇痛泵(PCA),观察组使用智能化自控镇痛泵(Ai-PCA),对比两组的镇痛情况及血流动力学、各项分娩指标、妊娠结局、产后出血及泌乳情况。结果观察组T1-T3的VAS疼痛评分低于对照组(P<0.05),而两组各时间点的MAP、HR相当(P>0.05);观察组产程时间短于对照组,罗哌卡因及舒芬太尼用量少于对照组,PCA追加次数少于对照组,镇痛满意度评分高于对照组(P<0.05),两组镇痛时间、10 min Apgar评分相当(P>0.05);观察组中转剖宫产、侧切率与对照组相当(P>0.05),低血压、恶心呕吐、皮肤瘙痒、尿潴留、发热等不良反应发生率低于对照组(P<0.05);观察组产后2h及24h出血量少于对照组,产后开始泌乳时间短于对照组,泌乳率高于对照组(P<0.05)。结论Ai-PCA对初产妇分娩镇痛有显著效果,能缩短产程,减少镇痛药物用量,对妊娠结局影响小,且能减少产后出血量,缩短泌乳时间。

Objective:To explore the effects of intelligent self-controlled analgesic pump on labor analgesic effect,pregnancy outcome and lactation function of primipara.Methods:From April 2021 to August 2022,220 parturient parturient women who underwent painless labor in the obstetrics department of Hengshui Maternal and Child Health Hospital of Hebei Province were divided into two groups by random number table method.Both groups received epidural anesthesia.The control group received conventional analgesia pump(PCA),and the observation group received intelligent automatic analgesia pump(Ai-PCA).The analgesia,hemodynamics,delivery indexes,pregnancy outcome,postpartum hemorrhage and lactation were compared between the two groups.Results:The VAS pain score of T1-T3 in the observation group was lower than that in the control group(P<0.05),and the MAP and HR of the two groups were similar at each time point(P>0.05).The duration of labor in the observation group was shorter than that in the control group,the dosage of ropivacaine and sufentanil was less than that in the control group,the number of PCA supplementation was less than that in the control group,and the analgesic satisfaction score was higher than that in the control group(P<0.05).The analgesic duration and 10-min Apgar score of the two groups were similar(P>0.05).The rates of cesarean section and lateral resection in observation group were similar to those in control group(P>0.05),and the incidence of adverse reactions such as hypotension,nausea and vomiting,skin pruritus,urine retention and fever were lower than those in control group(P<0.05).The blood loss 2h and 24h postpartum in the observation group was less than that in the control group,the time of postpartum lactation was shorter than that in the control group,and the lactation rate was higher than that in the control group(P<0.05).Conclusion:Ai-PCA has a significant effect on labor analgesia in primipara,which can shorten labor process,reduce the amount of analgesic drugs,have little effect on pregnancy outcome,reduce postpartum bleeding and shorten lactation time.