硬膜外镇痛给药的背景模式改变对妊娠结局的影响

Effects of Changes in Basal Medication Mode of Epidural Analgesic Administration on Pregnancy Outcome

目的:探讨硬膜外镇痛给药的背景模式改变对妊娠结局的影响。方法:以2015年1月～2017年12月期间于某院进行分娩的285例正常产妇作为此次研究对象,按照入院先后顺序将其分为对照组(2015年1月～2016年5月)与研究组(2016年6月～2017年12月),对照组给予0.1%盐酸罗哌卡因和0.5μg/ml舒芬太尼混合液10ml+硬膜外导管接自控镇痛泵进行镇痛,研究组在对照组的镇痛基础上加入背景输入式改变,对比两组镇痛效果及对妊娠结局的影响。结果:两组镇痛前VAS评分与镇痛持续时间对比差异均无统计学意义(P>0.05),研究组在宫口开6cm、10cm时VAS评分明显低于对照组,差异对比有意义(P<0.05);两组各产程时间以及留置尿管时间对比均无统计学意义(P>0.05);研究组导尿次数明显低于对照组,差异对比有意义(P<0.05);两组新生儿Apgar评分≤7分、呼吸评分以及胎儿窘迫现象差异对比均无统计学意义(P>0.05)。结论:采用硬膜外镇痛联合背景输入给药形式不仅能够达到更强的止痛效果,持续时间更长,并且不会对产妇的最终分娩方式以及新生儿结局产生影响,相对安全。

Objective:To discuss the influence of changes in basal medication mode of epidural analgesic administration on pregnancy outcome.Methods:285 healthy puerpera delivering from January 2015 to December 2017 in our hospital were selected.The subjects were divided into control group(2015.1~2016.5)and study group(2016.6~2017.12)according to the registration time.The control group took 0.1%of ropivacaine hydrochloride,10ml of 0.5μg/ml sufentanil mixtures and patient-controlled epidural analgesia pump;On the basis,the study group received the basal injection modes.The analgesia effect and pregnancy outcomes were observed.Results:Before intervention,the VAS points and duration of analgesia of two groups were not significantly different(P>0.05);With 6cm and 10cm of cervical dilation,the VAS points for study group were significantly lower than control group(P<0.05);The labor stage and indwelling time of catheter for two groups were not significantly different(P>0.05);The catheterization frequency for study group was significantly lower than control group(P<0.05);The rate for newborns with Apgar scores≤7,breathing scores and rate of fetal distress for two groups were not significantly different(P>0.05).Conclusion:The epidural analgesia and basal injection mode can improve the analgesia effect and extend the analgesia time.In addition,the final outcomes and the neonatal conditions are not affected.