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生物反馈式镇痛仪联合硬膜外麻醉分娩镇痛对初产妇分娩结局的影响

The effect of the biofeedback analgesic apparatus combined with epidural analgesia on primipara women
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摘要 目的探究生物反馈式镇痛仪联合硬膜外麻醉分娩镇痛对初产妇的镇痛效果,以及对分娩结局及质量的影响,为临床提供参考。方法选取在新疆维吾尔自治区人民医院分娩的初产妇作为研究对象,按患者意愿接受不同分娩镇痛方式进行分组,分为镇痛仪组(产妇给予生物反馈式的经皮电刺激镇痛)、硬膜外组(产妇给予硬膜外注射药物镇痛)和联合组(产妇同时给予生物反馈式经皮电刺激镇痛以及硬膜外注射药物镇痛)。根据纳入、排除标准,每组纳入40例。观察并记录3组产妇镇痛前即刻(T0)、镇痛后1 h(T1)、镇痛后2 h(T2)、宫口全开时(T3)视觉模拟评分、分娩方式、产程时间、会阴切开率、器械助产率、产后2 h出血量、新生儿Apgar评分及患者满意度。结果3组产妇一般情况比较差异无统计学意义(P>0.05);3组产妇T0时刻视觉模拟评分差异无统计学意义(P>0.05);3组产妇T1、T2、T3时刻较T0时刻视觉模拟评分低(P<0.05);联合组产妇T1、T2、T3时刻视觉模拟评分均低于镇痛仪组、硬膜外组产妇(P<0.05);联合组与硬膜外组产妇满意度高于镇痛仪组(P<0.05);硬膜外组产妇第一产程较镇痛仪组、联合组产妇长(P<0.05);3组产妇在第二、三产程、新生儿Apgar评分、剖宫产率、会阴切开率、器械助产率、产后2 h出血量等方面差异无统计学意义(P>0.05)。结论生物反馈式镇痛仪联合硬膜外麻醉分娩镇痛较单纯硬膜外麻醉分娩镇痛或单纯生物反馈式镇痛仪分娩镇痛的效果好,且不会影响产程和新生儿Apgar评分。 Objective To investigate the analgesic effect of the biofeedback analgesic apparatus combined with epidural analgesia on primipara women,and to explore it's impact on the on delivery outcomes and quality,thereby providing clinical insights.Methods The research was initiated in January 2022,selecting firsttime mothers who gave birth at the People's Hospital of Xinjiang Uygur Autonomous Region as the research subjects.And they were divided into 3 groups based on their preferences for different analgesic modalities during labor.These groups included the analgesic apparatus group(where participants received biofeedback percutaneous electrical nerve stimulation),the epidural group(where participants underwent epidural injection),and the combined group(which involved both biofeedback percutaneous electrical nerve stimulation and epidural injection).According to the inclusion and exclusion criteria,40 cases were included in each group,Pain scores measured by the visual analogue scale at baseline(T0),one hour post-intervention(T1),two hours post-intervention(T2),and upon full cervical dilation(T3),mode of delivery,duration of labor,rates of episiotomy and instrumental assistance,postpartum hemorrhage at two hours,Apgar scores for newborns,and patient satisfaction were systematically recorded.Results No significant differences were found in general clinical data among the 3 groups(P>0.05);no significant differences were found in the labor pain visual analogue scale scores before analgesia in the 3 groups(P>0.05).Maternal labor pain visual analogue scale scores at T1,T2 and T3 were lower than at T0 in the 3 groups(P<0.05);the labor pain visual analogue scale scores at T1,T2 and T3 in the combined group were lower than the analgesic apparatus group and the epidural group(P<0.05);degree of satisfaction in the combined and the epidural group was higher than the analgesic apparatus group(P<0.05);the first stage of labor in the epidural group was longer than that in the analgesic apparatus and the the epidural group(P<0.05);there were no significant differences in the second,third labor stage,or in the neonatal Apgar score,cesarean section rate,episiotomy rate,forceps midwifery rate,and 2-hour postpartum hemorrhage in 3 groups(P>0.05).Conclusion Transcutaneous electric stimulation by biofeedback combined with epidural analgesia has better analgesic effect during labor than simple epidural analgesia and simple transcutaneous electric stimulation by biofeedbacker,and will not affect the labor and neonatal prognosis.
作者 张雪利 古文玉 闫磊 Zhang Xueli;Gu Wenyu;Yan Lei(Department of Obstetrics,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Anesthesia Surgery Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处 《兰州大学学报(医学版)》 2024年第9期47-51,共5页 Journal of Lanzhou University(Medical Sciences)
基金 新疆维吾尔自治区人民医院院内资助项目(20200413)。
关键词 初产妇 生物反馈式镇痛仪 硬膜外麻醉 分娩镇痛 视觉模拟评分法 Apgar评分 primipara biofeedback analgesic apparatus epidural analgesia labor analgesia visual analogue scale Apgar score
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