舒芬太尼联合不同浓度罗哌卡因分娩镇痛对母体影响的研究

Effects of sufentanil combined with different concentrations of ropivacaine for labor analgesia on the maternal

目的:研究舒芬太尼联合不同浓度罗哌卡因阶梯式镇痛对分娩产程、应激指标、凝血功能的影响。方法:选择在本院待产的178例足月单胎妊娠初产妇并进行硬膜外分娩镇痛,随机分为阶梯镇痛组和常规镇痛组,观察两组产妇的产程情况以及分娩过程中的应激激素、疼痛介质含量以及分娩后的凝血功能指标。结果:阶梯镇痛组产妇的产程潜伏期时间短于常规镇痛组,活跃期时间、第2产程时间、第3产程时间与常规镇痛组比较无显著性差异;阶梯镇痛组产妇的血清PRL含量显著高于常规镇痛组,PA、NE、E、DYN、β-EP、SP、PGE2、5-HT、TF、TFPI、FPA、AT-III、DD含量与常规镇痛组比较无显著性差异。结论:舒芬太尼联合不同浓度罗哌卡因阶梯式镇痛的效果与常规镇痛方案相当,能够缩短产程的潜伏期、减轻疼痛对催乳素的抑制作用且不影响分娩过程中的应激程度、分娩后的凝血功能。

Objective：To study the effects of sufentanil combined with different concentration of ropivacaine for stepped analgesia on stage of labor,stress indexes and blood coagulation function.Methods：A total of 178 cases of full-term singleton primiparas who awaited delivery and received epidural labor analgesia in our hospital were selected and randomly divided into stepped analgesia group and routine analgesia group,and the stage of labor,levels of stress hormones and pain mediators during childbirth and blood coagulation function indexes after childbirth were observed between two groups.Results：The duration of latent phase of labor of stepped analgesia group was shorter than that of routine analgesia group while the duration of active phase of labor,the duration of second stage of labor and the duration of third stage of labor were not significantly different from those of routine analgesia group;serum PRL level of stepped analgesia group was significantly higher than that of routine analgesia group while PA,NE,E,DYN,β-EP,SP,PGE2,5-HT,TF,TFPI,FPA,AT-III and DD levels were not significantly different from those of routine analgesia group.Conclusion：Sufentanil combined with different concentration of ropivacaine for stepped analgesia is with equivalent effect to routine analgesia,and can shorten the latent phase of labor and reduce the inhibito-ry effect of pain on prolactin without affecting the degree of stress during childbirth and the blood coagulation function after childbirth.