镇痛分娩在妊娠期高血压患者中的应用

Application of analgesia in patients with pregnant hypertension syndrome

目的探讨镇痛分娩在妊娠期高血压患者中应用的价值。方法120例足月、单胎、头位、患妊娠期高血压的初产妇均无产科并发症和麻醉禁忌证，其中60例孕妇进行硬膜外镇痛分娩，另外60例作为对照组，观察镇痛分娩对呼吸循环、产程、产后出血的影响。结果①镇痛组镇痛后平均动脉压、心率、呼吸频率均有不同程度下降，与同时段对照组比较也明显降低。②镇痛组活跃期时间明显短于对照组（P〈0．01）。③镇痛组重度子痫前期发病率明显低于对照组（P〈0．01），镇痛组较对照组剖宫产率下降（P〈0．05）。④两组产后出血、胎儿宫内窘迫、新生儿窒息比较差异无统计学意义（P〉0．05）。结论妊娠期高血压产妇采用镇痛分娩可有效减轻宫缩疼痛，降低产程中重度子痫前期的发病率，同时缩短产程、增加顺产率，降低了产妇分娩的风险。

Objective To investigate the value of analgesia on patients with pregnant hypertension syndrome. Methods One hundred and twenty pregnant women with pregnant hypertension syndrome were devided into two groups. Sixty cases of pregnant women were treated by epidural analgesia （ test group）. Another 60 cases of pregnant women were in the control group. The effects of analgesia on respiration, circulation, labor and postpartum hemorrhage were observed and recorded. Results ① MAP, HR and RR decreased after analgesia in the test group, and were lower than those in the control group. ②Compared with the control group, the active time was shorter in the test group（ P 〈0. 01 ）. ③ The incidence of severe preeclampsia in the test group was lower than that in the control group significantly（ P 〈0.01 ）. The rate of cesarean section was higher in the test group（ P 〈0. 05）.④There were no significant differences in the occurrence of postpartum hemorrhage, neonatal suffocation or fetal respiratory distress between the two groups （ P 〉 0. 05 ）. Conclusions Epidural analgesia is benefit for pregnant women with pregnant hypertension syndrome, it can effectively reduce uterine pain and the incidence of severe preeelampsia, shorten labor, increase the normal childbirth rates, reduce the risk of childbirth.