程控硬膜外间歇脉冲注入与连续硬膜外输注在产妇分娩镇痛中的效果分析

Analysis of the Effect of Programmed Intermittent Epiduralboluses and Continuous Epidural Infusion in Maternal Labor Analgesia

目的探究在产妇分娩镇痛中应用程控硬膜外间歇脉冲注入(programmed intermittent epiduralboluses,PIEB)和连续硬膜外输注(continuous epidural infusion,CEI)的效果。方法方便选取2022年8月—2023年12月邳州市中医院收治的304例产妇为研究对象,依据麻醉方案不同分为对照组和观察组,各152例。对照组实施CEI方案,观察组实施PIEB方案。比较两组疼痛程度、应激指标、产程时间、不良反应发生率。结果观察组镇痛后30 min、宫口开全、分娩时、麻醉结束的视觉模拟评分法评分均低于对照组,差异有统计学意义(P均<0.05)。胎儿娩出时,观察组去甲肾上腺素水平为(455.67±48.83)ng/mL、醛固酮水平为(140.23±21.45)ng/L,均低于对照组的(478.56±50.51)ng/mL、(159.87±22.34)ng/L,差异有统计学意义(t=4.017、7.818,P均<0.05)。观察组第一、第二、第三产程时间均短于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在产妇分娩镇痛中应用PIEB方案,不仅镇痛效果显著,还能降低应激指标水平,缩短产程时间,安全性高。

Objective To explore the effect of programmed intermittent epiduralboluses(PIEB)and continuous epidu⁃ral infusion(CEI)in maternal labor analgesia.Methods A total of 304 parturients admitted to Pizhou Hospital of Tra⁃ditional Chinese Medicine from August 2022 to December 2023 were conveniently selected as the research objects.According to different anesthesia schemes,they were divided into control group and observation group,with 152 cases in each group.The control group implemented the CEI program,and the observation group implemented the PIEB program.The pain degree,stress indexes,labor time and incidence of adverse reactions were compared be⁃tween the two groups.Results The Visual Analogue Scale scores of the observation group were lower than those of the control group at 30 min after analgesia,complete cervical dilatation,delivery and the end of anesthesia,and the dif⁃ferences were statistically significant(all P<0.05).When the fetus was delivered,the norepinephrine level in the ob⁃servation group was(455.67±48.83)ng/mL,and the aldosterone level was(140.23±21.45)ng/L,which were lower than(478.56±50.51)ng/mL and(159.87±22.34)ng/L in the control group,and the differences were statistically signifi⁃cant(t=4.017,7.818,both P<0.05).The first,second and third stage of labor in the observation group were shorter than those in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of PIEB regimen in maternal labor analgesia not only has a significant analgesic effect,but also reduces the level of stress indi⁃cators,shortens the duration of labor,and has high safety.