高锦文

【摘要】 目的：探討程控硬膜外间歇脉冲输注与持续背景输注在初产妇分娩镇痛中的应用。方法：选取2018年4月-2019年4月本院收治的2 000例产妇为研究对象，随机数字表法分为对照组和研究组，各1 000例。对照组产妇分娩镇痛中应用持续背景输注，研究组应用程控硬膜外间歇脉冲输注。比较两组VAS评分、产程时间及麻醉药剂用量，观察两组不良反应发生情况。结果：两组T0、T1、T2、T3时间段VAS评分比较，差异均无统计学意义（P>0.05）;但T4、T5、T6时间段研究组VAS评分均显著低于对照组，差异均有统计学意义（P<0.05）。两组第一产程、第二产程、第三产程的时间比较，差异均无统计学意义（P>0.05）;研究组盐酸罗哌卡因及舒芬太尼的用量均低于对照组，差异均有统计学意义（P<0.05）。研究组产妇恶心呕吐、产时发热及皮肤瘙痒不良反应的发生率均低于对照组，差异有统计学意义（P<0.05）。研究组产妇的总满意率高于对照组，差异均有统计学意义（P<0.05）。结论：在初产妇分娩镇痛的过程当中，实施程控硬膜外间歇脉冲输注的效果理想，能够有效降低产妇镇痛2 h及以后时间段的痛疼程度，从而降低麻醉药剂的使用量及不良反应，提高了产妇的满意度，临床上应当进一步推广应用。

【关键词】 程控硬膜外间歇脉冲输注 持续背景输注 初产妇 分娩镇痛

Comparison of Application of Programmed Epidural Intermittent Pulse Infusion and Continuous Background Infusion in Labor Analgesia of Primipara/GAO Jinwen. //Medical Innovation of China， 2021， 18（01）： 0-054

[Abstract] Objective： To explore the application of programmed epidural intermittent pulse infusion and continuous background infusion in labor analgesia of primipara. Method： A total of 2 000 pregnant women admitted to our hospital from April 2018 to April 2019 were selected as the study subjects， they were divided into control group and study group by random number table method， 1 000 cases in each group. Continuous background infusion was used for labor analgesia in the control group， and programmed epidural intermittent pulse infusion was used in the study group. VAS score， labor time and dosage of anesthetic agents were compared between the two groups， the occurrence of adverse reactions in the two groups was observed. Result： Comparison of VAS scores in T0， T1， T2 and T3 periods between the two groups， the differences were not statistically significant （P>0.05）. However， VAS score of the study group were significantly lower than those of the control group at T4， T5 and T6， the differences were statistically significant （P<0.05）. There were no significant differences in the time of the first， second and third stages of labor between the two groups （P>0.05）. The dosage of Ropivacaine Hydrochloride and Sufentanyl in the study group were lower than those in the control group， the differences were statistically significant （P<0.05）. The incidence of nausea and vomiting， perinatal fever and skin pruritus in the study group were lower than those in the control group， the differences were statistically significant （P<0.05）. The total satisfaction rate was higher in the study group than in the control group， and the difference was statistically significant （P<0.05）. Conclusion： In the process of childbirth analgesia for first-time mothers， the implementation of program-controlled intermittent epidural pulse infusion has an ideal effect， which can effectively reduce the pain degree of pain for 2 h and the subsequent period of time， thus reducing the use of anesthetic agents and adverse reactions， and improving the satisfaction of puerpera. Therefore， it should be further promoted and applied in clinical practice.

[Key words] Programmed epidural intermittent pulse infusion Continuous background infusion Primipara

Labor analgesia

First-authors address： Jiangmen City Maternal and Child Health Hospital， Jiangmen 529000， China

doi：10.3969/j.issn.1674-4985.2021.01.013

分娩痛疼是产妇在分娩过程中出现的自然身体反应，痛疼的产生会对产妇的生理及心理造成严重的影响，尤其是对初产妇的影响更大，给予产妇有效的分娩镇痛能够降低其痛苦，因此镇痛的方法尤为重要[1]。目前临床中常用的镇痛方法是持续背景输注及患者硬膜外自控输注，但是临床中多项研究发现该种镇痛方法的效果并不是很理想[2]。在实际的麻醉中用药剂量较大，导致逐渐不被临床产妇所接受，随着医学技术的不断完善，程控硬膜外间歇脉冲输注逐渐出现[3]。但是临床中对于其分娩镇痛的相关文献较少，本文为探讨程控硬膜外间歇脉冲输注与持续背景输注在初产妇分娩镇痛中的应用，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年4月-2019年4月本院收治的2 000例产妇为研究对象，（1）纳入标准：①所有产妇为初产妇;②精神、意识无障碍，能够配合完成研究。（2……