妊娠期高血压疾病产妇无痛分娩对血清炎症因子和血流动力学的影响

The Effect of painless Delivery on Serum inflammatory Factors and Hemodynamics in Women with Hypertensive Disorder complicating Pregnancy

目的分析妊娠期高血压疾病(HDCP)产妇采取无痛分娩对其血清炎症因子、血流动力学产生的影响。方法选取2020年3月至2022年6月郑州市妇幼保健院收治的106例HDCP产妇,分成对照组(常规方式分娩)、观察组(无痛分娩),各53例,比较两组围产期指标、开始镇痛前(T_(1))、宫口开全时(T_(2))、娩出胎儿时(T_(3))及娩出胎儿24 h(T_(4))时间点的血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等炎症因子水平、心率(HR)、平均动脉压(MAP)及心输出量(CO)。结果观察组第一、第二、第三产程和初乳时间均短于对照组,1 min Apgar评分高于对照组,差异有统计学意义(P<0.05);两组5 min Apgar评分相比,差异无统计学意义(P>0.05)。两组T_(1)的TNF-α及IL-6水平比较,差异无统计学意义(P>0.05);观察组T_(2)、T_(3)、T_(4)的TNF-α及IL-6水平均低于对照组,差异有统计学意义(P<0.05)。两组T_(1)的MAP、HR及CO水平比较,差异无统计学意义(P>0.05);观察组T_(2)、T_(3)、T_(4)的MAP、HR及CO水平波动幅度小于对照组,差异有统计学意义(P<0.05)。结论HDCP产妇采取无痛分娩能降低其围产期的炎症因子水平,减轻血流动力学指标波动,是一类有效且安全的分娩方式。

Objective To analyze the effects of painless delivery on serum inflammatory factors and hemodynamics in pregnant women with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 106 HDCP pregnant women admitted to Zhengzhou Maternal and Child Health Hospital from March 2020 to June 2022 were selected and divided into a control group(conventional delivery)and an observation group(painless delivery),with 53 cases in each group.The levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),heart rate(HR),mean arterial pressure(MAP)and cardiac output(CO)were compared between the two groups in terms of perinatal indicators,pre analgesia(T_(1)),full opening of the cervix(T_(2)),delivery of the fetus(T_(3)),and 24-hour delivery of the fetus(T_(4)).Results The first,second,and third stages of labor and colostrum time in the observation group were shorter than those in the control group,and the 1-minute Apgar score was higher than that in the control group,with a statistically significant difference(P<0.05);There was no statistically significant difference in 5-minute Apgar scores between the two groups(P>0.05).There was no significant difference in the levels of TNF-αand IL-6 between the two groups(P>0.05).The levels of TNF-αand IL-6 of T_(2),T_(3) and T_(4) in the observation group were lower than those in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in MAP,HR,and CO levels between the two groups of T_(1)(P>0.05);MAP,HR and CO levels of T_(2),T_(3) and T_(4) in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Painless delivery for HDCP pregnant women can reduce their levels of inflammatory factors during the perinatal period,reduce fluctuations in hemodynamic indicators,and is an effective and safe delivery method.