硬脊膜穿破硬膜外阻滞对自然分娩初产妇焦虑情绪和分娩镇痛的影响

Effects of dural puncture epidural blockade on anxiety and labor analgesia of primiparous women during natural childbirth

目的探讨硬脊膜穿破硬膜外(DPE)阻滞对自然分娩初产妇焦虑情绪和分娩镇痛的影响。方法选取2023年1月至2024年1月在晋江市中医院接受椎管内分娩镇痛的180例初产妇进行回顾性分析,根据分娩镇痛方法不同分为DPE组和硬膜外(EP)阻滞组(EP组),每组90例。记录镇痛效果达到视觉模拟评分(VAS)≤1分的时间、罗哌卡因总用量、宫口开全时VAS评分、骶尾部阻滞不全发生率。记录产前和产后焦虑自评量表(SAS)评分。记录产妇不良反应发生情况。结果DPE组镇痛效果达到VAS评分≤1分的时间短于EP组,罗哌卡因总用量少于EP组,宫口开全时VAS评分、骶尾部阻滞不全发生率、产后SAS评分低于EP组,差异均有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对于自然分娩的初产妇而言,DPE阻滞可提供更完善的分娩镇痛效果、减轻产妇焦虑情绪。

Objective To investigate the effects of dural puncture epidural(DPE)blockade on the anxiety and labor analgesia of primiparous women during natural childbirth.Methods A retrospective analysis was conducted on 180 primiparous women who received intrathecal labor analgesia at Jinjiang Hospital of Traditional Chinese Medicine from January 2023 to January 2024.They were divided into two groups according to the method of labor analgesia:the DPE group and the epidural blockade group(EP group),with 90 cases in each group.The time to achieve a visual analogue scale(VAS)score≤1,total ropivacaine dosage,VAS score at full cervical dilation,and the incidence of sacrococcygeal blockade failure were recorded.Scores on the self-rating anxiety scale(SAS)before and after childbirth were documented,along with the occurrence of adverse reactions in parturients.Results The DPE group showed a shorter time to reach a VAS score≤1,used less total ropivacaine,had lower VAS scores at full dilation,and had a lower incidence of sacrococcygeal blockade failure compared to the EP group,with postpartum SAS scores also being lower(all P<0.05).There was no significant difference in the rate of adverse reactions between the two groups(P>0.05).Conclusion For primiparous women undergoing natural childbirth,DPE blockade provides more effective labor analgesia and reduces maternal anxiety.