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硬膜外镇痛辅以韩氏穴位神经刺激在潜伏期和活跃期分娩镇痛中的应用
Application of patient-controlled epidural analgesia combined with Han's acupoint nerve stimulation in labor analgesia during latent phase and active phase
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DOI:
作者:
罗威 赵继蓉 魏璐 李胜华
LUO Wei , ZHAO Jirong,WEI Lu ,LI Shenghua.
作者单位:
上海市嘉定区妇幼保健院
Jiading Maternal and Child Health Hospital, Shanghai,
关键词:
分娩镇痛 韩氏穴位神经刺激 潜伏期 活跃期
Labor Analgesia; Han's acupoint Nerve stimulation; Latent phase; Active phase
摘要:
目的 观察硬膜外自控镇痛(PCEA)辅以Han's穴位神经刺激(HANS)在潜伏期和活跃期分娩镇痛中的效果。方法 240例足月、单胎、头位、有镇痛需求的初产妇随机分为四组,每组60例。L组和A组分别在潜伏期和活跃期行硬膜外自控镇痛,LH组和AH组分别在潜伏期和活跃期行硬膜外自控镇痛和韩氏穴位神经刺激。比较4组产妇的镇痛效果、镇痛药物用量、PCEA按压有效比例(有效按压次数/总次数)、产程时间、分娩方式选择情况,镇痛对分娩、新生儿的影响,以及产妇满意度。结果 各组产妇镇痛效果良好,VAS评分各组间差异无统计学意义(P >0.05);L组、LH组第一产程时间更短(P <0.05),LH组、AH组第二产程时间更短(P <0.05),每小时镇痛药用量更少(P <0.05),阴道产率较高(P <0.05),器械产率较低(P <0.05);LH组产妇满意度高于其他3组(P <0.05)。结论 潜伏期硬膜外镇痛是一种全程有效的分娩镇痛方法,有助于缩短第一产程;辅以HANS穴位刺激能够有效的减少镇痛药用量,缩短第二产程,提高阴道产率,提高病人满意度,是一种安全、有效、舒适的分娩镇痛方法。
Objective To observe the effect of patient-controlled epidural analgesia(PCEA) combined with Han's acupoint nerve stimulation(HANS) on labor analgesia during latent phase and active phase. Method 240 full-term primiparas of a singleton in cephalic were enrolled and randomized into 4 groups with 60 patients in each group. Nullipara in group L received patient-controlled epidural analgesia (PCEA) during the latent phase, group A received PCEA during the active phase, group LH received PCEA and HANS during the latent phase, group AH received PCEA and HANS during the active phase. Compare the analgesic effect, analgesic drug dosage, effective ratio of analgesic pressing (effective number of pressings divided by total number), time of labor, mode of delivery, effect of analgesia on delivery, newborns and maternal satisfaction. Results Analgesic was effective and there was no significant difference in VAS scores among groups (P > 0.05). The group L and group LH had a shorter duration of the first stage (P < 0.05); the group LH and group AH had a shorter duration of the second stage (P < 0.05), less average analgesic consumption per hour (P < 0.05), higher vaginal delivery (P < 0.05), and lower device-assisted labor rate (P < 0.05); The maternal satisfaction in group LH was higher than other three groups (P < 0.05).Conclusion Latent epidural analgesia is an effective method of labor analgesia, which is helpful to shorten the first stage of labor, plus with HANS can effectively reduce the dosage of analgesics, shorten the second stage and increase the vaginal delivery rate, improving patient satisfaction, is a safe, effective, and comfortable way for labor analgesia.
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