笑气分娩镇痛对产妇及脐血血液流变学的影响

Effects of inhaling nitrous oxide for analgesia labor on hemorrheology of parturient and umbilical vein .

目的:观察笑气镇痛分娩对产妇及脐血血液流变学的影响。方法:随机将临产产妇分成笑气镇痛组(观察组)和非镇痛组(对照组)各30例,观察组宫口开大3cm时吸入50%笑气和50%氧气的混合气体镇痛,对照组则采用心理安慰、宫缩期按摩子宫等方法减轻产痛。观察比较两组产痛程度、产程时间、分娩方式、新生儿Apgar评分等。胎儿娩出后立即分别抽取脐静脉血和产妇末梢静脉血,检测血液流变学。结果:观察组的阵痛强度评分明显低于对照组(P<0·01),笑气镇痛分娩可以明显缩短产程的活跃期和总产程(P<0·05);对产妇血流变各指标无明显影响(P>0·05);可明显降低脐静脉血血流变的各项指标(P<0·01),降低其血液粘稠度。结论:笑气分娩镇痛效果明显并能有效地改善脐静脉血液流变学,从而有利于胎儿血液供应,而且对母体血液流变学无不良影响。

Objective：To observe the effects of inhaling nitwus oxide for analgesia labor（NOAL） on hemorrheology of parturient and umbilical vein, Methods：Sixty parturient were randomly divided into two groups. Thirty cases （ NOAL group） inhaled nitrous oxide premixed with oxygen （50% ：50% ） for analgesia labor when their cervix dilated to 3cm and thirty cases （ control group） accepted psychological alleviating , kneading uterus. The degree of labor pains, delivery process, delivery ways, Apgar scores and others were compared between the two groups. The blood were collected immediately from respectively parturients＇ peripheral vein and newborns＇umbilical vein after delivery and hemorrheology parameter were measured and compared. Results：The score of labor pains in the observational group was significantly lower than the control one （ P 〈 0. 01 ）. The duration of active phase and total delivery process in the NOALgroup was significantly shorter than that in the control one （ P 〈 0. 05 ）. The differences of hemorrheology parameter of parturient between NOAL group and control group were not statistically significant （ P 〉 0. 05 ）. The hemorrheology parameter of umbilical vein were decreased significantly in NOAL group （P 〈 0. 01 ）. Conclusion：The inhalation nitrous oxide for analgesia labor benefits to relent labor pains of parturient and to better hemorrheology of umbilical vein, The effects is not significant on hemorrheology of parturient.