摘要
目的观察经皮穴位电刺激联合硬膜外阻滞在无痛分娩中的应用及对分娩结局的影响。方法选取200例阴道试产的一胎产妇,按照随机数字表法分成对照组和观察组,每组100例。对照组给予硬膜外阻滞术,观察组在此基础上联合经皮穴位电刺激。观察两组产妇的分娩方式、产程时间和产后出血情况。记录两组产妇镇痛前及宫口开2 cm、4 cm、6 cm和宫口全开时的视觉模拟量表(VAS)疼痛评分。记录两组产妇镇痛前、镇痛1 h和2 h后血清β-内腓肽水平。记录两组新生儿动脉血气指标和出生1 min后的Apgar评分。结果观察组产妇的平均产程时间和剖宫产率明显低于对照组(P<0.05)。观察组患者产后2 h出血量、总出血量和产后大出血人数明显低于对照组(P<0.05)。镇痛后,两组患者VAS评分均明显下降(P<0.05),且观察组低于对照组(P<0.05)。两组血清β-内啡肽水平明显升高(P<0.05),且观察组高于对照组(P<0.05)。两组新生儿的动脉血气指标和出生1 min后的Apgar值比较差异均无统计学意义(P>0.05),安全性均较高。结论经皮穴位电刺激联合硬膜外阻滞有助于产妇缩短产程、降低剖宫产率,减少产后大出血的发生率,提高血清β-内腓肽水平减少VAS疼痛评分,且安全性较高。
Objective To observe the application of transcutaneous electrical acupoint stimulation(TEAS)combined with epidural block in painless labor and its effect on delivery outcome.Method A total of 200 primiparae planning for vaginal birth were recruited and divided into a control group and an observation group by the random number table method,with 100 cases in each group.The control group was given epidural block,while the observation group was given additional TEAS.The delivery mode,duration and postpartum bleeding were observed in the two groups.The Visual Analogue Scale score for pain was recorded before analgesia in the subjects and at 2 cm,4 cm,6 cm and full cervix dilation in the two groups.The serumβ-endorphin level was recorded before analgesia,and at 1 h and 2 h after analgesia in the two groups.The arterial blood gas index and the Apgar score 1 min after birth in the newborns were recorded.Result The average delivery duration and Cesarean section rate were significantly lower in the observation group than in the control group(P<0.05).The bleeding amount 2 h after birth,the total bleeding amount and the number of case of postpartum hemorrhage were significantly smaller in the observation group than in the control group(P<0.05).After analgesia,the VAS score decreased markedly in both groups(P<0.05),and was lower in the observation group than in the control group(P<0.05).The level of serumβ-endorphin increased significantly in the two groups(P<0.05),and was higher in the observation group than in the control group(P<0.05).There were no significant differences in the arterial blood gas index and Apgar score 1 min after birth between the two groups(P>0.05),suggesting comparatively high safety level in both groups.Conclusion TEAS plus epidural block can help shorten the delivery duration,reduce the Cesarean section rate and the incidence rate of postpartum hemorrhage,up-regulate the content of serumβ-endorphin and reduce the VAS pain score,with relatively high safety level.
作者
和静
王华
张瑞红
HE Jing;WANG Hua;ZHANG Rui-hong(Hebei Baoding No.4 Central Hospital,Baoding 072350,China)
出处
《上海针灸杂志》
2020年第10期1269-1273,共5页
Shanghai Journal of Acupuncture and Moxibustion
基金
保定市科技计划项目(16ZF182)。
