初产妇椎管内阻滞镇痛对产妇血清SP、NPY等因子水平及阴道助产率的影响分析

An analysis towards the effect of primipara intraspinal block analgesia on maternal serum SP,NPY and other factors and vaginal delivery rate

目的:分析初产妇椎管内阻滞镇痛对产妇血清疼痛应激因子P物质(SP)、神经肽Y(NPY)、神经生长因子(NGF)及前列腺素E2(PGE2)及阴道助产率的影响。方法:选取2016年8月~2018年8月来我院分娩的100例初产妇为研究对象,以麻醉药物为依据,分为两组,对照组行单纯罗哌卡因硬膜外镇痛,观察组行罗哌卡因联合舒芬太尼硬膜外镇痛,对比两组不同时间点血清疼痛应激因子水平、应激激素含量、分娩方式。结果:观察组产妇分娩后6h、分娩后12h以及分娩后24h时的SP、NPY、NGF、PGE2含量低于对照组,差异有统计学意义;观察组产妇分娩后6h、分娩后12h以及分娩后24h时的去甲肾上腺素(NE)、血管紧张素I(AngI)、血管紧张素Ⅱ(AngⅡ)以及皮质醇(Cor)含量低于对照组,差异有统计学意义;观察组自然分娩率高于对照组,剖宫产率低于对照组,差异有统计学意义。结论:初产妇采用罗哌卡因联合舒芬太尼硬膜外镇痛利于减轻疼痛程度,对应激反应进行抑制。

Objective To analyze the analgesia of puerperal spinal cord block in maternal serum pain stress factor substance P(P substance,SP),neuropeptide tyrosine(NPY),nerve growth factor(NGF)And the effect of prostaglandin E2(Rabbit Prostaglandin,PGE2)and vaginal helper.Methods 100 primiparas who were delivered to our hospital from August 2016 to August 2018 were selected as subjects.They were divided into two groups based on anesthetic drugs.The control group received simple epidural analgesia with ropivacaine.The patients underwent epidural analgesia with ropivacaine combined with sufentanil.The serum pain stress factor levels,stress hormone levels,and delivery methods were compared between the two groups at different time points.Results The levels of SP,NPY,NGF and PGE2 in the observation group were lower than those in the control group 6 h after delivery,12 h after delivery and 24 h after delivery.The difference was statistically significant.The observation group was 6 h after delivery and after delivery.Norepinephrine(NE),angiotensin I(AngI),angiotensin II(angiotensin II,Ang II)and cortisol(Cor)were lower than the control at 12h and 24h after delivery.The difference was statistically significant.The natural delivery rate of the observation group was higher than that of the control group,and the cesarean section rate was lower than that of the control group,the difference was statistically significant.Conclusion Epidural analgesia with ropivacaine combined with sufentanil in primipara is helpful in relieving pain and inhibiting stress response.