朱　彬　肖　纯　章方霞

杭州市妇产科医院杭州市妇幼保健院麻醉科，浙江杭州310000

椎管内推注地塞米松对于预防无痛分娩患者发热的作用及安全性研究

朱彬肖纯章方霞

杭州市妇产科医院杭州市妇幼保健院麻醉科，浙江杭州310000

目的探讨椎管内推注地塞米松对预防无痛分娩患者发热的作用及安全性研究。方法选自我院于2015年4月～2016年4月期间足月初产妇300例，均为要求分娩镇痛的产妇。依据随机数字表法随机分为观察组150例与对照组150例。对照组椎管内推注生理盐水，观察组椎管内推注地塞米松。比较两组第一产程结束和第二产程结束腹痛VAS评分、新生儿Apgar 1 min和5 min评分、产时发热情况及并发症发生情况。结果观察组第一产程结束和第二产程结束腹痛VAS评分明显低于对照组，差异有统计学意义（P＜0.05）；两组新生儿1 min和5 min Apgar评分比较差异无统计学意义（P＞0.05）；观察组产时发热情况明显低于对照组，差异有统计学意义（P＜0.05）；两组均未见严重并发症发生。结论椎管内推注地塞米松对于预防无痛分娩患者发热效果明显，对新生儿无影响，且可明显减轻腹痛，降低发热，且并发症少，安全性良好，值得研究。

地塞米松；无痛分娩；发热；安全性

［Abstract］Objective To discuss the effect and safety of dexamethasone intraspinal injection in prevention of fever in painless labor.Methods A total of 300 full-term nulliparous women delivering in our hospital from April 2015 to April 2016 were selected and all of them required labor analgesia.The patients were randomly divided into observation group and control group，each with 150 cases.Patients in the control group were given normal saline intraspinal injection，while those in the observation group were given dexamethasone intraspinal injection.The abdominal pain VAS scores at termination of the first and second stage of labor，Apgar scores of newborns at 1 and 5 min，fever，and incidence of complications were compared.Results The abdominal pain VAS scores at termination of the first and second stage of labor were significantly lower in the observation group than those in the control group（P＜0.05）.There was no significant difference in 1 min and 5 min Apgar scores of newborns at between two groups（P＞0.05）.The incidence of fever was significantly lower in the observation group than that in the control group（P＜0.05）.No severe complication was observed in either group.Conclusion Dexamethasone intraspinal injection has significant effect in prevention of fever in painless labor with no impact on newborns，which can significantly relieve abdominal pain，and lower the incidence of fever，showing few complications and favorable safety，thus is worthy to be further studied.

［Key words］Dexamethasone；Painless labor；Fever；Safety

分娩疼痛是一种生理现象，但因持续疼痛刺激，使得产妇焦虑、烦躁、痛苦，且可能在分娩过程中对胎儿、产妇产生不良影响。分娩镇痛方法可分为药物性镇痛和非药物性镇痛两大类。故而，为提高围产期质量，分娩镇痛越来越受到临床医师重视［1-3］。……