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腰硬联合麻醉分娩镇痛对妊娠期糖尿病母儿结局的影响 被引量:9

The effect of combined spinal-epidural analgesia on gestational diabetes mellitus
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摘要 目的探讨腰硬联合麻醉分娩镇痛(combined spinal-epidural analgesia,CSEA)对妊娠期糖尿病(gestational diabetes mellitus,GDM)母儿结局的影响。方法 2011年1-12月广州市妇女儿童医疗中心,选择已确诊GDM初产妇185例观察母儿结局,其中使用CSEA的93例为研究组;不使用CSEA的92例为对照组。结果活跃期2小时及3小时末梢血糖值比较,研究组明显低于对照组(P<0.05);且研究组活跃期的血糖相对平稳;活跃期末两组孕妇血清皮质醇水平比较,研究组明显低于对照组(P<0.05)。研究组脐血皮质醇水平明显低于对照组(P<0.05);研究组新生儿血糖明显高于对照组(P<0.05);研究组活跃期时间较对照组明显缩短(P<0.05);研究组剖宫产率明显低于对照组。结论腰硬联合麻醉分娩镇痛可能缩短GDM产妇的活跃期产程,可以减轻GDM产妇在分娩过程中内分泌的改变,改善新生儿血糖,降低剖宫产率,对母儿结局无不良影响。 Objective To study the influence of combined spinal-epidural analgesia(CSEA) on both newborns and mothers with gestational diabetes mellitus (GDM). Methods 185 primiparas were diagnosed as GDM, in which 93 cases with CSEA, were observed as a study group and the other 92 cases without CSEA were observed as control group. The outcome of newborns and mothers were determined. Results The blood sugar value in study group was significantly lower than that in the control in the 2^nd and 3^nd hours during active phase( P 〈 0. 05 ) and the blood sugar in study group is relatively stable . The serum cortisol of the pregnant in study group was significantly lower than those in the control at the end of the active phase( P 〈 0. 05 ). The cortisol in umbilical cord blood in study group was significantly lower than that in the control( P 〈0. 05 ). The blood sugar of newborns in study group was significantly higher than that in the control ( P 〈 0.05 ). The time of the active phase in study group was significantly shorter than that in the control ( P 〈 0. 05 ). Conclusion CSEA maybe could shorten the time of the active phase and effectively eliminate the fluctuation of blood sugar and serum cortisol in gestational diabetes mellitus, and also improve neonate outcomes.
出处 《中国实用妇科与产科杂志》 CAS CSCD 北大核心 2013年第11期894-897,共4页 Chinese Journal of Practical Gynecology and Obstetrics
基金 广州市医药卫生科技项目[穗卫科(2011)2号201102A213040]
关键词 妊娠期糖尿病 皮质醇 分娩镇痛 gestational diabetes mellitus cortisol combined spinal-epidural analgesia
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