腰硬联合麻醉在妊高症患者无痛分娩中的效果观察

Effect of combined spinal epidural anesthesia for painless labor in patients with pregnancy induced hypertension

目的:探讨针对妊娠高血压疾病(妊高症)患者实施腰硬联合麻醉无痛分娩的应用效果。方法:选取本院于2015年10月到2018年5月接收的200例妊高症产妇为研究对象,采用数字化列表将患者随机分为对照组和研究组,每组100例。对照组进行常规镇痛处理,研究组实施腰硬联合麻醉无痛分娩,观察并比较两组患者的分娩方式、镇痛效果、产程时间、住院时间以及并发症等相关指标。结果:对照组阴道分娩率为52.0%,研究组阴道分娩率为84.0%,差异具有统计学意义(P<0.05)。研究组镇痛总有效率高于对照组,差异具有统计学意义(P<0.05)。研究组第一产程时间短于对照组,差异具有统计学意义(P<0.05);第二产程、第三产程时间两组差异无统计学意义(P>0.05)。研究组pH、PO2指标均高于对照组,差异有统计学意义(P<0.05);而两组PCO2差异无统计学意义(P>0.05)。研究组住院时间少于对照组,差异具有统计学意义(P<0.05)。两组产后出血量和Apgar评分差异均无统计学意义(P>0.05)。研究组并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论:对妊高症患者在无痛分娩中实施腰硬联合麻醉的方法,镇痛效果显著,并可有效提高阴道分娩率,减少并发症的发生,具有较高的安全性和有效性。

Objective:To explore the application effect of combined spinal epidural anesthesia for painless labor in patients with pregnancy induced hypertension.Methods:200 cases of pregnant women with pregnancy induced hypertension treated in our hospital from October 2015 to May 2018 were selected as the research subjects.The patients were randomly divided into control group and study group with a digital list,100 cases in each group.The control group was treated with routine analgesia,and the study group were received painless labor combined with spinal epidural anesthesia.Then the difference of delivery mode,analgesic effect,duration of labor,hospitalization time and complications were observed and compared between the two groups.Results:The vaginal delivery rate of the control group was 52.0%,and that of the study group was 94.0%.The vaginal delivery rate of the control group was lower than that of the study group,the difference was statistically significant(P<0.05).The total effective rate of analgesia in the study group was statistically significant higher than that in the control group(P<0.05).The first labor time of the study group was statistically significant shorter than that of the control group(P<0.05);the second and third stage of labor time in the control group and the study group had no significant difference(P>0.05).The indexes of pH and PO2 in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05),while there was no significant difference in PCO2 between the two groups(P>0.05).The time of hospitalization of pregnant women in the control group was more than that of the study group,the difference was statistically significant(P<0.05).There was no significant difference between the control group and the study group on the amount of postpartum hemorrhage and the Apgar score(P>0.05).The total incidence of complications in the control group was significant higher than that in the study group(P<0.05).Conclusion:For pregnant patients with preeclampsia,the method of combined spinalepidural anesthesia in painless delivery has significant analgesic effect,effectively improves the rate of vaginal delivery,reduces the occurrence of complications,and has higher safety and effectiveness.