分娩镇痛对子痫前期患者血流动力学及分娩方式的影响

Effect of labor analgesia on hemodynamics and delivery methods in patients with preeclampsia

目的探讨分娩镇痛对子痫前期产妇血流动力学以及分娩方式的影响。方法将200例单胎子痫前期产妇按照是否行分娩镇痛分为两组,每组100例,研究组给予分娩镇痛,对照组不给予分娩镇痛。比较镇痛前、镇痛后10 min、镇痛后30 min、镇痛后1 h、宫口全开时两组平均动脉压、外周血管阻力、心率水平。比较两组产妇第一、第二、第三产程时间。比较两组产妇在宫口开大1 cm、3 cm、5 cm时视觉模拟评分法评分,比较分娩过程中两组产妇的分娩方式、缩宫素及降压药的使用率,比较两组产妇分娩完成后2 min及10 min新生儿Apgar评分。结果镇痛后10 min、镇痛后30 min、镇痛后1 h、宫口全开时研究组平均动脉压水平较镇痛前显著降低(P<0.05或0.01),对照组显著升高(P<0.01),研究组显著低于对照组(P<0.01)。镇痛后10 min、镇痛后30 min、镇痛后1 h、宫口全开时研究组外周血管阻力水平较镇痛前显著降低(P<0.01),显著低于对照组(P<0.01)。宫口全开时研究组心率水平显著高于镇痛前(P<0.01)。研究组第一产程、第二产程及第三产程均显著长于对照组(P<0.05)。研究组宫口开大1 cm、3 cm、5 cm时视觉模拟评分法评分均显著低于对照组(P<0.01)。研究组缩宫素使用率及阴道分娩率显著高于对照组(P<0.01),降压药物使用率显著低于对照组(P<0.01)。两组分娩后2 min及10 min新生儿Apgar评分比较差异无统计学意义(P>0.05)。结论分娩镇痛可有效降低子痫前期产妇的应激反应,缓解分娩过程中的痛苦,提高顺产率,保证母婴安全,值得临床推广。

Objective To investigate the effect of labor analgesia on hemodynamics and delivery methods in patients with preeclampsia.Methods A total of 200 women with pre-eclampsia were divided into two groups according to whether they received labor analgesia,100 cases each group.The study group was given labor analgesia and the control group was not given labor analgesia.The mean arterial pressure(MAP),systemic vascular resistance(SVR),and heart rate levels of the two groups were compared before analgesia,10 minutes after analgesia,30 minutes after analgesia,1 hour after analgesia,and when the uterus was opened.Compare the time of the first,second and third stages of labor between the two groups.The visual analogue scale(VAS)scores were compared between the two groups of parturients when the uterine opening was 1 cm,3 cm,and 5 cm,and the delivery methods,oxytocin and antihypertensive drug use rates of the two groups were compared during delivery.The Apgar scores of newborns at 2 min and 10 min after delivery were compared between the two groups.Results The MAP level in the observation group at 10 minutes,30 minutes,1 hour after analgesia,and full opening of the uterus was significantly lower than before analgesia(P<0.05 or 0.01),and the control group was significantly increased(P<0.01),the study group was significantly lower than the control group(P<0.01).The SVR levels in the study group were significantly lower than before analgesia at 10 minutes,30 minutes,1 hour after analgesia,and full opening of the uterus(P<0.01),and significantly lower than those in the control group(P<0.01).The first,second and third stages of labor in the study group were significantly longer than those in the control group(P<0.05).The VAS scores of the study group when the uterine opening was 1 cm,3 cm,and 5 cm were significantly lower than those of the control group(P<0.01).The use rate of oxytocin and vaginal delivery in the study group were significantly higher than those in the control group(P<0.01),and the use of antihypertensive drugs was significantly lower than in the control group(P<0.01).There was no significant difference in the Apgar scores of the newborns between the two groups at 2 min and 10 min after delivery(P>0.05).Conclusions The delivery analgesia can effectively reduce the stress response of preeclampsia women,relieve the pain during childbirth,increase the rate of childbirth,and ensure the safety of mother and child.It is worthy of clinical promotion.