心理支持疗法联合患者自控硬膜外镇痛对分娩的影响

Perioperative psychological supporting therapy combined with patient controlled epidural analgesia for labor analgesia

目的:评估心理支持疗法(PPST)联合患者自控硬膜外镇痛(PCEA)用于分娩镇痛的效果。方法:120例产妇随机分为Ⅰ组(PPST组)、Ⅱ组(PCEA组)、Ⅲ组(PPST+PCEA组)和Ⅳ组(对照组),比较4组产妇焦虑状况、镇痛效果、新生儿情况以及产妇分娩情况。结果:Ⅰ、Ⅲ组产妇焦虑自评量表评分(SAS)于PPST后显著下降(P<0.05);Ⅰ组产妇镇痛效果优于Ⅳ组(P<0.05),但较Ⅱ组和Ⅲ组差(P<0.05),Ⅱ组与Ⅲ组镇痛效果相似,但Ⅲ组PCEA和催产素用量比Ⅱ组减少(P<0.05)。结论:PPST联合PCEA用于分娩镇痛,可强化镇痛并减少用药量。

Objective： To observe the effect of perioperative psychological supporting therapy （PPST）in labor analgesia combined with patient controlled epidural analgesia（PCEA）. Methods：A total of 120 pregnant women were randomly assigned to four groups： group Ⅰ with PPST; group Ⅱ with PCEA; groupⅢ with PPST＋PCEA and group Ⅳ without treatment. The effect of analgesia, newborns Apgar scores, anxiety state, and delivery situation were observed and compared. Results. The degree of anxiety in group Ⅰand group Ⅲ were reduced after administration of PPST （P〈0.05）. The maternal analgesia in group Ⅰ was more effective than group IV, but less efficacious than group Ⅱ and group Ⅲ （P〈0.05）. With the similar analgesia between group Ⅱ and group Ⅲ, the dosage of PCEA and oxytocin decreased in group Ⅲ （P〈0.05）. Conclusions： Coadministration of PPST with PCEA could be beneficial for relieving labor analgesia and reducing the medicament.