| 徐进辉,熊丹丹.经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛对母婴的影响[J].实用中西医结合临床,2022,22(14): |
| 经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛对母婴的影响 |
| 经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛对母婴的影响 |
| 投稿时间：2022-08-09 修订日期：2022-09-02 |
| DOI： |
| 中文关键词: 经皮穴位电刺激 瑞芬太尼 全产程 分娩镇痛 母婴 |
| 英文关键词: |
| 基金项目:经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛对产妇胎盘灌注及催乳素与催产素影响 |
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| 中文摘要: |
| 目的 通过对经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛对母婴的影响研究为临床用药提供参考。方法 选择因恐惧拒绝椎管内穿刺且符合条件自愿行静脉分娩镇痛的初产妇60例,随机分成两组：瑞芬太尼镇痛组(R 组,30例)和经皮穴位电刺激辅助瑞芬太尼镇痛组(TR组,30例)。分别记录产妇镇痛前(T0),宫口扩张3cm (T1) 、5cm (T2) 、10cm (T3) 、胎儿娩出(T4) 5个时间点镇痛视觉模拟评分(VAS)；平均动脉压 (MAP)、心率 (HR) 以及胎心率 (FHR)变化；记录电子镇痛泵自控按压次数及瑞芬太尼的总用量；各产程总时间及镇痛期间不良反应发生率情况；新生儿的出生后Apgar评分、脐动脉血乳酸值；分别于镇痛前(T0)、产后48h(T5)时间点取静脉血样,采用ELISA法测定血清催乳素含量。结果：不同时间点的MAP、HR、FHR,产程时间、产钳助产及剖宫产率,胎儿娩出后1min和5min的Apgar评分及脐动脉血乳酸值差异比较均无统计学意义(P＞0.05)；与T0相比,R组和TR组在T1-4的镇痛评分VAS显著下降,组间比较差异无统计学意义(P＞0.05)；不良反应中以头晕、恶心呕吐的发生率TR组较R组明显降低(P＜0.05),且自控按压次数和瑞芬太尼总用量亦降低(P＜0.05)；分娩后两组产妇催乳素含量显著上升,但两组间比较差异无统计学意义(P＞0.05)。结论 经皮穴位电刺激辅助瑞芬太尼全产程静脉分娩镇痛可有效减轻产妇的产痛且带来的不良反应发生率更低,对母婴安全可靠,值得在临床上进一步推广使用。 |
| 英文摘要: |
| Objective To investigate the effect of percutaneous acupoint electrical stimulation combined with remifentanil on maternal and infant analgesia. Methods a total of 60 parturient women who voluntarily underwent intravenous labor analgesia were randomly divided into remifentanil analgesia group (R group, 30 cases) and transcutaneous acupoint electrical stimulation combined with remifentanil analgesia group (TR group, 30 cases). VAS scores were recorded at 5 time points before analgesia (T0), uterine orifice dilation of 3cm (T1), 5cm (T2), 10cm (T3), and fetal delivery (T4). MAP, HR and FHR; The number of PCIA presses was recorded and the total amount of remifentanil was calculated. The results of Apgar score and umbilical artery blood gas analysis after delivery were recorded. Venous blood samples were taken at T0 before analgesia and T5 48h after delivery, and serum prolactin was determined by ELISA. Results There were no significant differences in MAP, HR, FHR, labor duration, forceps assisted labor rate, cesarean section rate, Apgar score 1 min and 5 min after delivery and umbilical blood lactic acid value between the two groups at different time points (P > 0.05). Compared with T0, VAS scores in T1-4 were significantly lower in R and TR groups. There was no significant difference between TR group and R group in VAS score at each time point. The incidence of dizziness, nausea and vomiting |
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