罗哌卡因连续硬膜外阻滞分娩镇痛对产妇泌乳素水平及新生儿神经行为的影响分析

Effect of continuous epidural analgesia with ropivacaine on maternal prolactin level and neonatal neurobehavior

目的:探讨采用罗哌卡因进行硬膜外阻滞分娩镇痛对产妇泌乳素水平及新生儿神经行为的影响。方法:将2016年7月至2017年7月间本院分娩的220例初产妇作为研究对象,分为观察组与对照组,每组患者110例,运用罗哌卡因连续硬膜外阻滞的方式对观察组产妇进行分娩镇痛,对照组产妇不采用任何干预措施。比较分娩期间疼痛评分、产后泌乳素水平以及新生儿出生后apgar和神经行为评分等情况。结果:观察组产妇疼痛评分低于对照组,差异有统计学意义(P <0.05);两组产妇泌乳素水平与新生儿神经行为评分比较,差异无统计学意义(P> 0.05)。观察组活跃期时间与对照组活跃期时间比较差异有统计学意义(P <0.05)。观察组的第二产程、第三产程时间及新生儿出生后各时间点的Apgar评分均差异无统计学意义(P> 0.05)。产妇焦虑和抑郁的检出率低于对照组患者(P <0.05)。分娩后14 d,观察组新生儿的三项神经行为得分均高于对照组新生儿,差异具有统计学意义(P <0.05)。结论:运用罗哌卡因进行分娩镇痛具有良好的效果,对产妇泌乳素水平及新生儿神经行为无明显影响,值得临床应用推广。

Objective: To investigate the effect of continuous epidural analgesia with ropivacaine on maternal prolactin level and neonatal neurobehavior. Methods: A total of 220 primiparous women who gave birth in our hospital from July 2016 to July 2017 were enrolled as subjects and were randomly divided into observation group and control group, with 110 women in each group. The women in the observation group received continuous epidural analgesia with ropivacaine, and those in the control group received no intervention. The two groups were compared in terms of pain score during delivery, postpartum prolactin level, and Apgar score and neurobehavioral score of neonates after birth. Results: The observation group had a significantly lower pain score than the control group(P < 0.05),while there were no significant differences in prolactin level and neurobehavioral score of neonates between the two groups(P >0.05). There was a significant difference in the duration of active period between the observation group and the control group(P < 0.05). There were no significant differences in the duration of the second and third stages of labor and Apgar score of neonates at each time point after birth between the observation group and the control group(P >0.05). The observation group had significantly lower detection rates of anxiety and depression than the control group(P < 0.05). On day 14 after birth, the observation group had significantly higher scores of three neurobehaviors of neonates than the control group(P < 0.05). Conclusion: Labor analgesia with ropivacaine has a marked clinical effect, with no marked influence on maternal prolactin level and neonatal neurobehavior, and therefore, it holds promise for clinical application.