硬膜外镇痛给药的背景模式改变对妊娠结局的影响

Influence of changing background mode of epidural analgesia drug on pregnancy outcome

目的 探讨两种分娩镇痛方法 对妊娠结局及镇痛期间不良事件发生率的影响.方法 采用回顾性研究,选取2013年11月1日—2014年3月31日,实施EA＋PCEA镇痛方法 的足月、单胎头位且无头盆不称及妊娠合并内科疾病等产科病理情况的正常产妇121人作为对照组;同时选取相同条件下2014年11月1日—2015年3月31日期间实施EA＋背景模式PCEA镇痛方法 的正常产妇110人作为观察组.采用数字评定量表（NRS）对两组产妇分娩后10 min、30 min、1 h的疼痛状况进行评估,同时比较两组研究对象不良妊娠结局和不良事件的发生率.结果 两组比较,1 h NRS评分差异具有统计学意义（P〈0.01）.对照组、观察组导尿次数差异具有统计学意义（P〈0.01）.两组产程时间、产后出血、最终分娩方式、新生儿结局比较,差异无统计学意义（P〉0.05）.结论 EA＋背景输入的PCEA镇痛形式止痛效果更好、更持久,对产妇的最终分娩方式、产后出血量和新生儿结局没有影响.

Objective To investigate the influence of two labor analgesia methods on pregnancy outcomes and incidence of adverse events during analgesia. Methods The study retrospectively investigated 121 healthy parturient women as the control group who received EA＋PCEA analgesia from November 2013 to March 2014 and had full-term, single fetal head fetus without obstetric pathological conditions such as cephalopelvic disproportion or pregnancy with internal diseases. The observation group included 110 healthy parturient women who received EA ＋ PCEA within background mode from November 2014 to March 2015. Numeric rating scale （ NRS） was used to evaluate the pain at 10 min, 30 min, and 1 h after the delivery. Meanwhile, adverse pregnancy outcome and incidence of adverse events were compared between two groups. Results 1 h NRS score and urinary catheterization times had statistical differences （P 〈0. 01）. But the differences of duration of labor, postpartum hemorrhage, delivery mode and neonatal outcome between two groups had no statistical significance （P〉0. 05）. Conclusions EA＋PCEA within background mode performs better in effective and lasting analgesia, but has no influence on postpartum hemorrhage, delivery mode and neonatal outcome.