产前减压辅助盐酸罗哌卡因硬膜外注射在减轻高龄孕产妇分娩疼痛中的应用

Application of antepartum decompression in assisting epidural injection of ropivacaine hydrochloride to alleviate labor pain in elderly pregnant women

目的研究产前减压辅助盐酸罗哌卡因硬膜外注射对减轻高龄孕产妇分娩疼痛的效果。方法选取2020年8月至2022年12月进行分娩的高龄孕产妇134例,按红蓝球法分为观察组(n=66)和对照组(n=68)。对照组采用盐酸罗哌卡因硬膜外注射麻醉,观察组在对照组麻醉方案基础上加以实施产前减压干预措施,对比2组分娩情况[第一、二、三产程疼痛采用数字评估量表(NRS),焦虑、抑郁分别采用汉密尔顿焦虑(HAMA)量表,汉密尔顿抑郁(HAMD)量表,围产期情况,分娩情况,新生儿阿氏(Apgar)评分不良事件]。结果观察组第一、二、三个产程的NRS、HAMA和HAMD评分、早产率、并发症率和剖宫产率低于对照组,总产程和住院时间更短,产后出血量更少,产妇配合度和新生儿Apgar评分更高,差异均有统计学意义(P<0.05)。结论采用产前减压辅助盐酸罗哌卡因硬膜外注射方案应用于高龄孕产妇,可对孕产妇分娩进行有效镇痛,对于其焦虑和抑郁情绪有所缓解,孕产妇分娩结局更好,产后恢复速度更快,安全性高,值得临床广泛应用。

Objective To study the effect of antepartum decompression in assisting epidural injection of ropivacaine hydrochloride on alleviating labor pain in elderly pregnant women.Methods A total of 134 elderly pregnant women delivered in our hospital from August 2020 to December 2022 were selected and divided into two groups according to the red and blue ball method,with 66 cases in the observation group and 68 cases in the control group.Postpartum women in both groups were anesthetized by epidural injection of ropivacaine hydrochloride,and those in the observation group were additionally managed by antepartum decompression.Delivery conditions were compared between groups,including the Numeric Pain Rating Scale(NRS)in the first,second and third stage of labor,the Hamilton Anxiety Rating Scale(HAM-A),the Hamilton Depression Rating Scale(HAM-D),perinatal conditions,delivery condition,the Apgar score,and adverse events.Results Postpartum women in the observation group had significantly lower NRS,HAMA and HAMD scores in the first,second and third stage of labor,preterm delivery rate,complication rate and cesarean section rate,shorter delivery time and length of stay,less postpartum bleeding,and higher neonatal Apgar score and maternal cooperation than those of control group(P<0.05).Conclusion Antepartum decompression in assisting epidural injection of ropivacaine hydrochloride effectively provides analgesia to elderly pregnant women,which alleviates anxiety and depression,provides a better labor outcome,faster postpartum recovery and high safety.It is worthy of a wide clinical application.