分娩镇痛对妊娠期高血压疾病阴道分娩的效果

Effect of delivery analgesia on vaginal delivery of women with hypertensive disorder complicating pregnancy

目的观察给予分娩镇痛后妊娠期高血压疾病产妇的阴道分娩率。方法选择患有妊娠期高血压疾病、血压范围在18．7～20．6／12．0～14．0kPa（140～155／90～105mmHg）、随机尿蛋白≤＋＋、无子痫发作及其他合并症，经阴道试产的孕妇58例进行回顾性分析。随机将患者分两组，A组给予Spinocath导管连续鞘内注药分娩镇痛30例；B组未予任何分娩镇痛药28例。结果产时A组产妇平均动脉压低于B组（t=2．391，P〈0．05）；A组产妇阴道分娩率高于B组，而剖宫产率则低于B组，差异有统计学意义（X^2=5．678，P〈0．05）。两组产妇的产程时间及新生儿窒息率比较差异均无统计学意义（均P〉0．05）。结论给予分娩镇痛后能明显提高妊娠期高血压疾病产妇的阴道分娩率。

Objective To observe the vaginal delivery rate of pregnant women with hypertensive disorder complicating pregnancy （HDCP） after receiving delivery analgesia. Methods The data of 58 cases with trial of vaginal delivery were retrospectively analyzed. With HDCP, their blood pressure was in the range of 18.7-20.6/12.0-14.0kPa （ 140-155/90-105mmHg）, random urinary protein~〈 ＋ ＋. No eclamptic seizures and other complications were found. The cases were randomly divided into two groups, group A （ n = 30） was given Spinocath catheter continuous intrathecal drug delivery for analgesia, and group B （ n = 28 ） had not any labor analgesia medicine. Results Mean arterial pressure of cases in group A was lower than that in group B （ t = 2.391, P 〈 0.05 ）. In group A vaginal delivery rate was higher but cesarean section rate was lower, and the differences were significant （X^2 = 5. 678, P 〈 0.05 ）. Duration of labor and neonatal asphyxia rate of two groups were not significantly different （ both P 〉 0.05 ）. Conclusion Labor analgesia can significantly improve the vaginal delivery rate of cases with HDCP.