评估引导下不同穿刺技术对初产妇智能化病人自控镇痛分娩镇痛效应的影响

The effect of different puncture techniques on labor analgesia of Ai-PCA for primiparas

目的探讨对比评估引导下不同穿刺技术对初产妇分娩智能化病人自控镇痛(Ai-PCA)效应的影响.方法选择收治的150例宫口开至3 cm的足月初产妇,随机数字表法分为对照组(PCEA组)、硬膜穿破组(DPE组)、腰硬联合阻滞组(CSEA组),每组50例.采用评估引导下Ai-PCA方式脉冲泵分娩镇痛,记录镇痛效果、影响分娩、新生儿状况及不良反应的发生情况.结果3种方式镇痛效果显示CSEA组镇痛起效速度快于PCEA组和DPE组(P<0.05),DPE组镇痛效果持续时间较长且VAS评分较低(P<0.05);DPE组产前发热、皮肤瘙痒等并发症发生率低于另外两组(P<0.05);满意度PCEA组低于CSEA组和DPE组(P<0.05).结论分娩镇痛之前医生评估引导下采用人先智能化脉冲泵Ai-PCA模式DPE是一种安全有效的分娩镇痛方式,降低产妇及胎儿的不良反应发生率,提高产妇综合舒适满意度,值得临床推广选用.

Objective To investigate the effect of different puncture techniques on intelligent patient-controlled analgesia(Ai-PCA)for parturient.Methods A total of 150 full-term primipara were randomly divided into PCEA group,DPE group and CSEA group(n=50).Labor analgesia with Ai-PCA pulse pump under the guidance of evaluation was used.The influence on labor,neonatal condition and incidence of adverse reactions were recorded.Results The analgesic effect of CSEA group was significantly faster than PCEA group and DPE group(P<0.05).The analgesic effect of DPE group significantly lasted longer and the provided lower VAS score(P<0.05).The incidence of complications,such as prenatal fever and skin itching,in DPE group was significantly lower than those of the other two groups(P<0.05).Satisfaction degree of PCEA group was significantly lower than those of CSEA group and DPE group(P<0.05).Conclusion Before labor analgesia,the artificial intelligence pulse pump(Ai-PCA)mode is adopted under the guidance of doctors'evaluation.DPE is a safe and effective method for labor analgesia,which can reduce the incidence of adverse reactions of parturient and fetus,and improve the comprehensive comfort satisfaction of parturient.