连续硬膜外麻醉复合硬膜外自控镇痛第二产程中不关闭镇痛泵对产后出血的影响

The effect of continuous epidural anesthesia combined with automatic control analgesia pump epidural during the second stage of labor on their postpartum hemorrhage

目的:探讨连续硬膜外麻醉复合硬膜外腔置管连接自控镇痛泵第二产程中不关闭镇痛泵对产后出血的影响。方法:选择2018年6月-2019年7月于本院分娩的产妇120例为研究对象,按照随机数字表法分为两组各60例。均给予连续硬膜外麻醉复合硬膜外腔置管连接自控镇痛泵镇痛,在第二产程中对照组关闭镇痛泵,观察组不关闭镇痛泵。比较两组不同时间镇痛效果、产后出血情况及分娩方式、新生儿不良结局。结果:观察组镇痛后视觉模拟疼痛评分(VAS)30min(1.9±0.7分)、60min(1.5±0.6分)、90min(1.3±0.9分)均低于对照组(2.1±0.6分、1.9±0.7分、1.8±1.0分),产后2h、12h、24h出血量(115.3±19.3ml、158.7±23.7ml、188.6±28.5ml)、止血起效时间(16.2±2.2min)均低于对照组(153.4±25.0 ml、214.2±32.2 ml、265.6±35.2 ml,23.3±2.4min)(均P<0.05);分娩方式、新生儿不良结局发生率与对照组无差异(P>0.05)。结论:连续硬膜外麻醉复合硬膜外腔置管连接自控镇痛泵第二产程中不关闭镇痛泵,镇痛效果更佳。

Objective:To investigate the effect of continuous epidural anesthesia combined with automatic control analgesia pump epidural during the second stage of labor of pregnant women on their postpartum hemorrhage.Methods:A total of 120 pregnant women were selected in this study and were divided into two groups(60 cases in each group)according to the random number table method from June 2018 to July 2019.All the women were given continuous epidural anesthesia combined with epidural catheter connected self-controlled analgesic pump for labor analgesia.The women in the control group turned off analgesic pump during the second stage of labor,and the women in the study group continually used the analgesic pump during the second stage of labor.The analgesic effects at different time,postpartum hemorrhage,and delivery mode of the women,and the adverse neonatal outcomes were compared between the two groups.Results:VAS scores at 30 min(1.9±0.7 points),60 min(1.5±0.6),and 90 min(1.3±0.9 points)after analgesia of the women in the study group were significantly lower than those(2.1±0.6 points,1.9±0.7 points,and 1.8±1.0 points)of the women in the control group.The blood loss at postpartum 2 h,12 h,and 24 h(115.3±ml,158.7±23.7 ml,and 188.6±28.5 ml),and the onset time of hemostasis(16.2±2.2 min)of the women in the study group were significantly lower than those(153.4±25.0 ml,214.2±32.2 ml,and 265.6±35.2 ml,and 23.3±2.4 min)of the women in the control group(all P<0.05).There were no significant differences in the delivery mode and the incidence of neonatal adverse outcomes between the two groups(P>0.05).Conclusion:Continuous epidural anesthesia combined with epidural catheter connected automatic control analgesic pump during the second stage of labor of the pregnant women has better analgesic effect.