持续硬膜外分娩镇痛在子痫前期患者阴道分娩中的应用效果

Application Effect of Continuous Epidural Labor Analgesia in Vaginal Delivery of Patients with Preeclampsia

目的:观察持续硬膜外分娩镇痛在子痫前期患者阴道分娩中的应用效果。方法:选取笔者所在医院2019年6月-2020年12月收治的60例子痫前期患者,根据患者意愿将其分为镇痛组(30例)和对照组(30例)。镇痛组接受持续硬膜外分娩镇痛,对照组未实施分娩镇痛。比较两组产程时间、宫口开3 cm时与宫口全开时血压水平,并统计母婴结局。结果:两组第一产程比较差异无统计学意义(P>0.05), 镇痛组第二、三产程与总产程均短于对照组,镇痛组第二产程时疼痛评分低于对照组,差异均有统计学意义(P<0.05)。两组宫口开3 cm时收缩压及舒张压比较,差异无统计学意义(P>0.05), 镇痛组宫口开全时与宫口开3 cm时比较差异无统计学意义(P>0.05), 对照组宫口开全时收缩压及舒张压均高于宫口开3 cm时,且高于镇痛组,差异有统计学意义(P<0.05)。镇痛组剖宫产率为20.00%、产后出血率为3.33%,均低于对照组的50.00%、23.33%,而阴道分娩率为80.00%,高于对照组的50.00%,差异均有统计学意义(P<0.05)。镇痛组新生儿Apgar评分高于对照组,新生儿并发症发生率为6.67%,低于对照组的23.33%,差异均有统计学意义(P<0.05)。结论:持续硬膜外分娩镇痛应用于子痫前期患者阴道分娩中,可明显缩短第二、三产程与总产程时间,产妇在分娩过程中的血压水平平稳,降低剖宫产率,提升阴道分娩率,改善新生儿Apgar评分,减少新生儿并发症,降低产妇产后出血率,效果理想。

Objective:To observe the effect of continuous epidural labor analgesia in vaginal delivery of patients with preeclampsia.Method:A total of 60 patients with preeclampsia admitted in our hospital from June 2019 to December 2020 were selected and divided into the analgesia group(30 cases)and the control group(30 cases)according to their wishes.The analgesia group received continuous epidural labor analgesia.The control group was not given labor analgesia.The time of labor stage,blood pressure level at 3 cm and full opening of uterine orifice were compared between the two groups,and maternal and infant outcomes were analyzed.Result:There was no significant difference in the first labor stage between the two groups(P>0.05).The second and third labor stage and the total labor stage in the analgesia group were shorter than those in the control group,while the pain score in the second labor stage in the analgesia group was lower than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups at 3 cm opening of uterine orifice(P>0.05).There was no significant difference between the full opening of uterine orifice and the 3 cm opening of uterine orifice in the analgesia group(P>0.05).The systolic blood pressure and diastolic blood pressure at full opening of uterine orifice were higher than those at 3 cm opening of uterine orifice in the control group,and higher than those of the analgesia group,the differences were statistically significant(P<0.05).The cesarean section rate and postpartum hemorrhage rate of the analgesia group were 20.00%and 3.33%,which were lower than 50.00%and 23.33%of the control group,while the vaginal delivery rate of the analgesia group was 80.00%,which was higher than 50.00%of the control group,the differences were statistically significant(P<0.05).The neonatal Apgar score of the analgesia group was higher than that of the control group,and the incidence of neonatal complications was 6.67%,which was lower than 23.33%of the control group,the differences were statistically significant(P<0.05).Conclusion:Continuous epidural labor analgesia in vaginal delivery of patients with preeclampsia can significantly shorten the time of the second and third stages of labor and the total stage of labor,stabilize the maternal blood pressure level in the process of delivery,reduce the cesarean section rate,improve the vaginal delivery rate,improve the neonatal Apgar score,reduce neonatal complications,and reduce maternal postpartum hemorrhage rate,the effect is ideal.