硬脊膜穿破硬膜外阻滞用于分娩镇痛的效果与安全性分析

Analysis of Effect and Safety of Dural Puncture Epidural Technique for Labor Analgesia

目的:探讨硬脊膜穿破硬膜外阻滞(DPE)用于分娩镇痛的效果与安全性。方法:选取2020年5月—2023年2月在绥宁县人民医院及洞口县妇幼保健计划生育服务中心自然分娩并行分娩镇痛的100例初产妇作为研究对象,采用随机数字表法分为对照组与试验组,各50例。对照组接受传统硬膜外镇痛,试验组接受DPE镇痛。比较两组镇痛效果。结果:试验组硬膜外给药后10 min、20 min及宫口全开时的疼痛评分低于对照组,差异有统计学意义(P<0.05)。两组不同时刻改良运动阻滞评分比较,差异无统计学意义(P>0.05)。试验组镇痛起效时间短于对照组,爆发痛发生次数、硬膜外自控镇痛按压次数、补救阵痛次数少于对照组,产妇满意度评分高于对照组,差异有统计学意义(P<0.05)。两组第一产程时间、第二产程时间、顺产率、器械助产率、并发症发生率比较,差异无统计学意义(P>0.05)。结论:DPE应用于初产妇分娩镇痛,能有效缓解分娩疼痛,提高产妇满意度,并且不会增加不良反应,值得临床应用。

Objective:To investigate the effect and safety of dural puncture epidural (DPE) technique for labor analgesia.Methods:A total of 100 primipara who had spontaneous delivery and received labor analgesia in Suining County People's Hospital and Dongkou County Maternal and Child Health and Family Planning Service Center and from May 2020 to February 2023 were selected as the study subjects.They were divided into control group and test group according to random number table method,with 50 cases in each group.The control group received traditional epidural analgesia,and the test group received DPE analgesia.The analgesia effects of the two groups were compared.Results:The pain scores in the test group at 10 min,20 min after epidural administration and upon uterine opening were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of modified motor blockade between the two groups at different time points (P>0.05).The onset time of analgesia in the test group was shorter than that in the control group,the number of pain outbreaks,the number of epidural patient-controlled analgesia compressions,and the number of remedial analgesia in the test group were lower than those in the control group,and the primipara satisfaction score in the test group was higher than that in the control group,and the difference was statistically significant (P<0.05).There were no significant differences between the two groups in the time of first stage of labour,time of second stage of labour,spontaneous delivery rate,instrumental delivery rate,and complication rate (P>0.05).Conclusion:The application of DPE in labor analgesia of primipara can effectively relieve labor pain,increase primipara satisfaction,and will not increase adverse reactions.It is worthy of clinical application.