摘要
目的:研究硬膜外规律间断给药对初产妇分娩镇痛效果及神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、β淀粉样蛋白(Aβ)的影响。方法:选取我院2018年1月至2019年3月接受分娩镇痛的86例初产妇纳入研究对象,以简单随机分组法分为观察组与对照组,每组43例。两组患者均行硬膜外分娩镇痛,观察组硬膜外规律间断给药,对照组硬膜外持续给药。对比两组产妇镇痛前后视觉模拟评分(VAS)及NSE、S100β、Aβ水平变化,另外对比两组分娩方式及镇痛期间不良反应发生情况。结果:组间对比,两组镇痛前及镇痛后不同时点VAS评分对比差异无统计学意义(P>0.05);组内对比,两组镇痛后不同时点VAS评分显著低于镇痛前,差异有统计学意义(P<0.05)。观察组自然分娩率显著高于对照组,阴道助产、剖宫产率显著低于对照组,差异有统计学意义(P<0.05)。两组镇痛前后NSE、S100β、Aβ水平对比差异无统计学意义(P>0.05)。两组镇痛期间不良反应发生率对比(9.30%vs16.28%),差异无统计学意义(P>0.05)。结论:硬膜外规律间断给药及硬膜外持续给药均可用于初产妇的分娩镇痛,镇痛效果满意,药物不良反应发生率低,可维持NSE、S100β、Aβ平衡,相对之下硬膜外规律间断给药具有自然分娩率高的优势,具有较高的临床应用价值。
Objective:To study the effect of intermittent epidural administration on labor analgesia and the effects of neuron specific enolase(NSE),S100βprotein(S100β)and amyloidβprotein(Aβ)in primipara.Methods:86 primiparas received labor analgesia from January 2018 to March 2019 in our hospital were selected into the study object.They were divided into observation group and control group by simple random grouping method,43 cases in each group.Two groups of patients were given epidural labor analgesia,the observation group of epidural regular intermittent administration,the control group of epidural continuous administration.The changes of vas,NSE,S100βand aβlevels before and after analgesia were compared between the two groups.In addition,the delivery mode and adverse reactions during analgesia were compared between the two groups.Results:There was no significant difference in VAS score between the two groups at different time points before and after analgesia(P>0.05).The VAS score of the two groups at different time points after analgesia was significantly lower than that before analgesia(P<0.05).The natural delivery rate in the observation group was significantly higher than that in the control group,and the rates of vaginal midwifery and cesarean section were significantly lower than those in the control group(P<0.05).There was no significant difference in NSE,S100βand Aβlevels between the two groups before and after analgesia(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(9.30%vs 16.28%)during analgesia(P>0.05).Conclusion:Both regular intermittent epidural administration and continuous epidural administration can be used for labor analgesia of primipara with satisfactory analgesic effect and low incidence of adverse drug reactions.They can maintain the balance of NSE,S100βand Aβ.In contrast,regular intermittent epidural administration has the advantage of high natural delivery rate and has high clinical application value.
作者
刘玉梅
王占晖
张秀欣
宋秀云
LIU Yumei;WANG Zhanhui;ZHANG Xiuxin(Jiaozhou Central Hospital of Qingdao, Shandong Qingdao 266300, China)
出处
《河北医学》
CAS
2020年第4期677-681,共5页
Hebei Medicine
基金
山东省青岛市卫计委,(编号:2018-WJZD077)。
关键词
初产妇
分娩镇痛
给药方式
分娩结局
Primipara
Labor analgesia
Drug delivery mode
Outcome of childbirth
