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41卷第5期
穴位神经刺激联合病人自控硬膜外镇痛在潜伏期分娩镇痛中的应用
Application of acupoint neuro-stimulation (HANS) combined with patient-controlled epidural analgesia (PCEA) on latent labor analgesia
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DOI:
作者:
赵继蓉, 罗威,李胜华
ZHAO Jirong ,LUO Wei ,LI Shenghua
作者单位:
上海市嘉定区妇幼保健院
Shanghai Jiading Maternal and Child Health Hospital
关键词:
潜伏期分娩镇痛;穴位神经刺激仪;自控硬膜外镇痛;产妇满意度
Latent period labor analgesia; Acupoints neuro-stimulator; Controlled epidural analgesia; Maternal satisfaction
摘要:
目的:观察穴位神经刺激仪(HANS)联合病人自控硬膜外镇痛(PCEA)在潜伏期分娩镇痛中的效果。方法:选择进入潜伏期(有规则宫缩,宫口开1cm)、足月单胎头位、要求分娩镇痛的初产妇120例,随机等分为3组,每组40例。H组为韩氏穴位神经刺激仪(HANS)组、P组为病人自控硬膜外镇痛(PCEA)组、HP组为韩氏穴位神经刺激仪(HANS)联合病人自控硬膜外镇痛(PCEA)组。再配对选择40例同期未行分娩镇痛的初产妇作为C组。结果:H组镇痛30min后各时间点VAS评分比镇痛前和C组相应时间点低(p<0.05),比P组、HP组相同时间点高(p<0.05);P组与HP组各时间点VAS评分无差异(p>0.05)。与HP组相比,P组平均每小时用药量多(p<0.05),按压的有效比例更低(p<0.05)。第一产程HP组较H组、P组、C组短(p<0.05),P组较H组和C组短(p<0.05);第二产程P组较H组、HP组、C组长(p<0.05);HP组产妇满意度有显著性提高(p<0.05),分别比C组提高了92.5%,比H组提高了90%,比P组提高了5%。结论:韩氏穴位神经刺激仪联合病人自控硬膜外镇痛能有效地减轻分娩疼痛,减少局麻药用量,缩短第二产程,提高产妇满意度。
Objective: To observe the effect of acupoint neuro-stimulation (HANS) combined with patient-controlled epidural analgesia (PCEA) on latent labor analgesia. Method: 120 cases of primipara-full term, single-fetus, head position, entry latency (regular contractions, cervix open 1cm) that required labor analgesia were randomly divided into three groups of 40 cases. Parturient women in group H received analgesia from HANS, in group P received patient controlled epidural analgesia (PCEA), while in HP group received HANS plus PCEA. In addition, 40 parturient women who did not undergo labor analgesia during the same period were selected as group C. Result: The VAS scores of H group at 30min after analgesia were lower than those before and at the corresponding time of C group (p <0.05), and significantly lower than those of P group and HP group (P <0.05). There was no difference in VAS scores between P group and HP group at each time point (p> 0.05). Compared with HP group, the average hourly consumption of drug in group P was significantly higher (p <0.05), and the effective proportion of press times was lower (p <0.05). The first stage of labor in HP group was shorter than the other three groups (P <0.05). The first stage of labor in P group was shorter than H group and C group (P <0.05). The second stage of labor in P group was longer than the other three groups (P <0.05). The satisfaction rate of maternal in HP group increased significantly, which was 92.5% higher than that of C group, 90% higher than that of H group and 5% higher than that of P group (P <0.05). Conclusion: HANS + PCEA can effectively relieve the pain of labor, reduce the amount of local anesthetic, shorten the second stage of labor, and improve the maternal satisfaction.
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