摘要
目的观察腰硬联合阻滞分娩镇痛对子痫前期孕妇分娩及胱抑素C、尿微量白蛋白的影响。方法将120例子痫前期孕妇分为观察组及对照组,每组60例。观察组采用腰硬联合阻滞分娩镇痛,对照组不采用分娩镇痛。比较两组产妇分娩方式、第一产程时间、第二产程时间和新生儿Apgar评分。分别于潜伏期、活跃期、第二产程、产后2 h及产后42 d测定两组自然分娩孕妇胱抑素C水平。分别于分娩前1天及分娩后第1天、第2天、第42天测定两组自然分娩孕妇尿微量白蛋白水平。结果观察组剖宫产率及第一产程时间均低于对照组(均P<0.05),而两组孕妇第二产程时间及新生儿5 min Apgar评分比较,差异均无统计学意义(均P>0.05)。观察组自然分娩孕妇各时间点的胱抑素C及尿微量白蛋白水平均低于对照组(均P<0.05);观察组自然分娩孕妇产后第42天胱抑素C正常率高于对照组(P<0.05),而两组自然分娩孕妇产后第42天尿微量白蛋白正常率差异无统计学意义(P>0.05)。结论腰硬联合阻滞分娩镇痛能够降低子痫前期孕妇剖宫产率,促进第一产程进展,降低子痫前期自然分娩孕妇分娩过程及产后胱抑素C、尿微量白蛋白水平,而对新生儿出生后5 min Apgar评分无影响。
Objective To observe the effect of labor analgesia with combined spinal-epidural block on preeclampsia pregnant women′s delivery and cystatin C and urinary microalbumin. Methods A total of 120 preeclampsia pregnant women were divided into observation group and control group,with 60 cases in each group.The observation group used combined spinal-epidural block for labor analgesia,while the control group did not use labor analgesia.Maternal delivery mode,duration of the first stage of labor,duration of the second stage of labor,and neonatal Apgar score were compared between the two groups.Cystatin C level of pregnant women with spontaneous labor was determined in both groups in the latent phase,active phase,second stage of labor,hour 2 postpartum,and day 42 postpartum.Urinary microalbumin level of pregnant women with spontaneous labor was detected in both groups on day 1 prenatally,and days 1,2 and 42 postpartum. Results Cesarean section rate and duration of the first stage of labor in the observation group were lower than those in the control group(all P <0.05),furthermore,no statistically significant difference was found between the two groups in duration of the second stage of labor or neonatal 5-minute Apgar score(all P >0.05).At each time point,pregnant women with spontaneous labor in the observation group obtained lower levels of cystatin C and urinary microalbumin compared with the control group(all P <0.05);the observation group reported a higher proportion of pregnant women with spontaneous labor having normal cystatin C on day 42 postpartum than the control group( P <0.05),furthermore,there was no statistically significant difference between the two groups with respect to the proportion of pregnant women with spontaneous labor having normal cystatin C on day 42 postpartum( P >0.05). Conclusion Labor analgesia with combined spinal-epidural block can reduce the rate of cesarean section of pregnant women with preeclampsia,promote the progression of the first stage of labor,decrease intra-delivery and postpartum levels of cystatin C and urinary microalbumin in pregnant women with preeclampsia and spontaneous labor,but has no effects on neonatal 5-minute Apgar score.
作者
劳诚毅
朱茂灵
王宗杰
黄玲
蒋汛
LAO Cheng-yi;ZHU Mao-ling;WANG Zong-jie;HUANG Ling;JIANG Xun(Department of Anesthesiology,Nanning Maternal and Child Health Hospital,Nanning 530011,China)
出处
《广西医学》
CAS
2019年第7期808-811,826,共5页
Guangxi Medical Journal
基金
广西南宁市科学研究与技术开发计划(20173017-7)
广西医药卫生科研课题(Z20170713)
