妊娠期高血压产妇硬膜外分娩镇痛时应激反应及肾功能指标水平观察

Observation on stress response and renal function indexes of pregnant women with hypertension during epidural labor analgesia

目的分析妊娠期高血压产妇硬膜外分娩镇痛时应激反应及肾功能指标水平.方法选择河北省涿州市医院接诊的106例妊娠期高血压产妇作为研究对象,分为镇痛组(62例)和非镇痛组(44例).在镇痛前及胎儿娩出时检测应激反应指标及肾功能指标,记录产程时间及Apgar评分.结果镇痛组胎儿娩出时血清去甲肾上腺素、肾上腺素、促肾上腺皮质激素、皮质醇水平均低于非镇痛组,差异均有统计学意义(P<0.05);镇痛组胎儿娩出时血清胱抑素C水平低于非镇痛组,差异有统计学意义(P<0.05);镇痛组活跃期及第二产程均短于非镇痛组,新生儿出生后1min、5min的Apgar评分均高于非镇痛组,差异均有统计学意义(P<0.05).结论硬膜外分娩镇痛能有效减轻妊娠期高血压产妇分娩时应激反应,保护肾功能,在一定程度上改善妊娠结局,值得临床予以重视.

0bjective To analyze stress response and renal function indexes of pregnant women with hypertension during epidural labor analgesia.Methods 106 cases of pregnant women with hypertension in our hospital were selected as the research object,which were divided into analgesic group(62 cases)and non-analgesic group(44 cases).Stress response indexes and renal function indexes were measured before analgesia and at delivery and labor time and Apgar score were recorded.Results The levels of norepinephrine,epinephrine,adren ocorticotropic hormone and cortisol in the analgesic group were lower than those in the non--analgesic group,with statistical significance(P<0.05).The serum cystatin Clevel in analgesia group was lower than that in non-analgesia group at delivery,and the difference was statistically significan(P<0.05).The active stage and the second stage of labor in analgesia group were shorter than those in non-analgesia group,and the Apgar score at 1min and 5min after birth was higher than that in non-analgesia group,with statistical sigificance(P<0.05).Conclus ion Epidural labor analgesia can effectively reduce stress response during delivery,proteet renal function and improve pregnancy outcome to a certain extent,which is worthy of clinical attention.