程控硬膜外间歇脉冲注入镇痛模式与持续硬膜外输注镇痛模式在分娩镇痛中的应用效果比较

Comparison of effects of programed intermittent epidural bolus analgesia mode and continuous epidural infusion analgesia mode in labor analgesia

目的:比较程控硬膜外间歇脉冲注入(PIEB)镇痛模式与持续硬膜外输注(CEI)镇痛模式在分娩镇痛中的应用效果。方法:选取63例产妇作为研究对象,按照随机数字表法分为对照组31例和观察组32例。对照组给予CEI模式镇痛,观察组给予PIEB模式镇痛,比较两组不同时间点疼痛程度[视觉模拟评分法(VAS)评分]、应激指标[醛固酮(ALD)、去甲肾上腺素(NE)]水平、分娩方式和新生儿5 min Apgar评分。结果:T_(1)、T_(2)、T_(3)时,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);胎儿娩出时,观察组ALD、NE水平均低于对照组,差异有统计学意义(P<0.05);观察组自然分娩率高于对照组,差异有统计学意义(P<0.05);两组新生儿5 min Apgar评分比较,差异无统计学意义(P>0.05)。结论:PIEB镇痛模式应用于分娩镇痛,可降低T_(1)、T_(2)、T_(3)时VAS评分和应激指标水平,提高自然分娩率,其效果优于CEI镇痛模式效果,但两种镇痛模式的新生儿5 min Apgar评分相当。

Objective:To compare effects of programed intermittent epidural bolus(PIEB)analgesia mode and continuous epidural infusion(CEI)analgesia mode in labor analgesia.Methods:63 parturients were selected as the research objects,and were divided into control group(31 cases)and observation group(32 cases)according to the random number table method.The control group was given CEI mode analgesia,while the observation group was given PIEB mode analgesia.The pain degree[visual analogue scale(VAS)score],stress index[aldosterone(ALD),norepinephrine(NE)]levels,delivery mode and 5 min Apgar scores of newborns were compared between the two groups at different time points.Results:At T_(1),T_(2),and T_(3),the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).When the fetus was delivered,the ALD and NE levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The proportion of natural childbirth in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the 5 min Apgar score between the two groups(P>0.05).Conclusions:The IEB analgesia mode for labor analgesia can reduce the VAS scores and stress index levels at T_(1)、T_(2) and T_(3)and increase the proportion of natural childbirth.Moreover,it is superior to CEI analgesia mode.However,the 5 min Apgar scores of the newborns of the two analgesia modes are comparable.