硝酸甘油与硫酸镁治疗椎管内分娩镇痛后子宫肌强直收缩的治疗效果分析

Analysis of the Therapeutic Effect of Nitroglycerin and Magnesium Sulfate in the Treatment of Uterine Muscle Rigidity and Contraction After Intraspinal Labor Analgesia

目的对比椎管内分娩镇痛后子宫肌强直收缩中应用硝酸甘油以及硫酸镁治疗的效果。方法选择2020年3月—2021年3月医院产科接诊的产妇90例,产妇均使用椎管内分娩镇痛,在镇痛期间出现子宫肌强直收缩伴胎心下降。使用随机数字表法分为两组,对照组(45例)采用硫酸镁治疗,观察组(45例)采用硝酸甘油治疗,将两组产妇治疗效果进行对比。结果观察组的强直宫缩缓解时间(1.52±0.33)min、胎心恢复正常时间(1.72±0.22)min短于对照组(2.48±0.22)min、(3.16±0.52)min,观察组收缩压(123.11±9.32)mmHg与舒张压(71.23±7.96)mmHg均小于对照组(131.63±9.79)mmHg、(76.89±8.95)mmHg,观察组的缩宫素使用剂量(1.72±0.12)U小于对照组(2.60±0.05)U,差异有统计学意义(P<0.05)。观察组新生儿出生后1 min、出生后5 min、出生后10 min的Apgar评分(9.13±0.32)分、(9.66±0.25)分、(9.88±0.11)分均高于对照组(8.90±0.21)分、(9.20±0.33)分、(9.11±0.13)分,差异有统计学意义(P<0.05)。观察组不良反应(宫缩乏力、新生儿肌张力低、头痛、恶心呕吐、下肢发麻、心动过缓、低血压)发生率(6.67%),低于对照组(24.44%),差异有统计学意义(χ^(2)=5.414,P<0.05)。结论椎管内分娩镇痛后子宫肌强直收缩产妇采用硝酸甘油治疗的效果理想,具有较高的可控性,产妇不良反应较少,对于产妇后期子宫收缩无不良影响,值得进行使用与推广。

Objective To compare the effects of nitroglycerin and magnesium sulfate in the treatment of uterine muscle rigidity and contraction after intraspinal labor analgesia.Methods Selected 90 cases of parturients who were admitted to hospital obstetrics from March 2020 to March 2021.The parturients all used intraspinal delivery analgesia.During the analgesia,uterine muscle rigidity and contraction with fetal heart rate decreased.The random number table method was used to divide into two groups.The control group(45 cases)was treated with magnesium sulfate,and the observation group(45 cases)was treated with nitroglycerin.The treatment effects of the two groups were compared.Results The remission time of tetanic contractions in the observation group(1.52±0.33)min and the recovery time of fetal heart rate(1.72±0.22)min were shorter than that in the control group(2.48±0.22)min and(3.16±0.52)min.Systolic blood pressure(123.11±9.32)mmHg and diastolic blood pressure(71.23±7.96)mmHg in the observation group were lower than those in the control group(131.63±9.79)mmHg and(76.89±8.95)mmHg.The dosage of oxytocin in the observation group(1.72±0.12)U was lower than that in the control group(2.60±0.05)U,the difference was statistically significant(P<0.05).Apgar scores(9.13±0.32)points,(9.66±0.25)points,(9.88±0.11)points in the observation group were higher than those in the control group(8.90±0.21)points,(9.20±0.33)points,(9.11±0.13)points at 1 min,5 min and 10min after birth,the difference was statistically significant(P<0.05).The incidence of adverse reactions(uterine weakness,low neonatal muscle tone,headache,nausea and vomiting,lower limb numbness,bradycardia,hypotension)in the observation group(6.67%)was lower than that in the control group(24.44%),the difference was statistically significant(χ^(2)=5.414,P<0.05).Conclusion After intraspinal analgesia,the treatment of uterine myotonic contraction by nitroglycerin is ideal,with high controllability,and fewer adverse maternal reactions.It has no adverse effects on the late uterine contraction of the parturient and is worthy of use and promotion.