硬膜外分娩镇痛对子痫前期产妇肾功能的影响

Effect of epidural labor analgesia on renal function of parturients with preeclampsia

目的观察硬膜外分娩镇痛对子痫前期产妇肾功能的影响。方法选取足月顺产的子痫前期单胎头位初产妇50例,其中硬膜外分娩镇痛和非硬膜外分娩镇痛的各25例。记录两组入产房时、入产房后4 h的疼痛评分和平均动脉压;测定两组入产房时、分娩后24 h尿微量白蛋白、尿微量蛋白/肌酐、血肌酐、尿素氮、尿酸;记录新生儿Apgar评分和脐动脉血气。结果硬膜外分娩镇痛组入产房后4 h的疼痛评分和平均动脉压均显著低于对照组(P=0.001,0.001),两组产妇分娩后24 h的尿微量蛋白、血肌酐、尿素氮、尿酸水平差异无统计学意义,硬膜外分娩镇痛组产妇分娩后24 h尿微量白蛋白/肌酐显著低于对照组(P=0.01)。两组间新生儿Apgar评分和脐动脉血气分析无显著差异。结论硬膜外分娩镇痛可以降低子痫前期产妇的尿微量白蛋白/肌酐水平,对子痫前期产妇肾功能有一定的保护作用。

Objective To observe the effect of epidural labor analgesia on renal function of parturients with preeclampsia.Methods Fifty singleton cephalic primiparas with preeclampsia who planned vaginal delivery were selected,among which 25 chose epidural labor analgesia or 25 did not.Pain scores and mean arterial pressure were recorded when and 4 h after entering the delivery room.Urine microalbumin,urine microprotein/creatinine,blood creatinine,urea nitrogen and uric acid were measured when entering the delivery room and 24 h after delivery.Apgar score and umbilical arterial blood gas were recorded.Results The pain score and mean arterial pressure in labor analgesia group was significantly lower than that in control group 4 h after entering the delivery room(P=0.001,0.001).There were no significant differences in urinary microprotein、serum creatinine、urea nitrogen and uric aicd between the two groups 24 h after delivery.Urinary microalbumin/creatinine in labor analgesia group was significantly lower than that in control group 24 h after delivery(P=0.01).There were no significant differences in Apgar score and umbilical arterial blood gas between the two groups.Conclusion Epidural labor analgesia can reduce urinary microalbumin/creatinine levels in preeclampsia parturients,and has a certain protective effect on renal function in preeclampsia parturients.