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| 不同材质硬膜外导管用于程控硬膜外脉冲注射对分娩镇痛效果的影响 |
| Effects of programmed intermittent epidural bolus combined with different epidural catheters on labor analgesia |
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| DOI：10.12089/jca.2021.07.004 |
| 中文关键词: 硬膜外导管 分娩镇痛 程控硬膜外注射 不良事件 |
| 英文关键词: Epidural catheter Labor analgesia Programmed intermittent epidural bolus Adverse events |
| 基金项目:南京医科大学发展基金面上项目（2017NJMU078，NJMUB2018141） |
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| 中文摘要: |
目的 观察不同材质硬膜外导管用于程控硬膜外脉冲注射（PIEB）对分娩镇痛效果及不良事件的影响。
方法 选择拟行硬膜外分娩镇痛初产妇200例，年龄24～30岁，BMI＜30 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将产妇分为两组：钢丝加强型硬膜外导管组（S组）和普通塑料硬膜外导管组（N组），每组100例。两组均连接程控硬膜外脉冲注射泵行硬膜外分娩镇痛，PIEB参数一致。记录给药后2、4、8 h的VAS疼痛评分，记录单侧阻滞的发生情况及中转剖宫产的例数，记录不良事件及产妇满意度。
结果 给药后4、8 h，S组VAS疼痛评分明显低于N组（P＜0.05）。两组单侧阻滞和中转剖宫产比例差异无统计学意义。与N组比较，S组置管阻塞、置入血管、重新穿刺比例、置管时一过性麻木比例、注药受阻比例、导管打折和拉长比例以及固定导管处渗血、拔管后出血比例明显降低（P＜0.05）。S组产妇满意度明显高于N组（P＜0.05）。
结论 加强型钢丝硬膜外导管用于PIEB能改善分娩镇痛的效果，减少分娩镇痛期间不良事件的发生，提高产妇满意度。 |
| 英文摘要: |
Objective To observe the effects of programmed intermittent epidural bolus (PIEB) with epidural catheters of different materials on labor analgesia.
Methods A total of 200 primiparas who received epidural labor analgesia, aged 24-30 years, BMI < 30 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups: common epidural tube group (group S) and reinforced epidural tube group (group N), 100 in each group. The corresponding epidural catheter was inserted in each group after successful epidural puncture. The PIEB parameters were the same in each group during epidural labor analgesia. VAS score 2, 4, and 8 hours after administration was observed. The proportion of unilateral block and the transit cesarean section, the occurrence of adverse events and the satisfaction rate of parturients were recorded.
Results Compared with group N, the incidences of blocking during the catheter placement, the proportion of blood that was drawn back and the need to re-puncture the catheter was significantly reduced, the proportion of paresthesia during insertion, the number of catheters kinked, elongated and blocked during injections,and the proportion of bleeding after extubation were decreased significantly (P < 0.05). There was no statistically significant difference in other adverse events in the two groups. VAS score of group S was lower than that of group N at 4 and 8 hours after injection (P < 0.05). There were no significant differences in the incidence of transit caesarean section and the block incompleteness between the two groups. The satisfaction rate of parturients in group S was significantly higher than that in group N (P < 0.05).
Conclusion PIEB combined with reinforced epidural catheter can improve the labor analgesia effects, reduce the incidence of related adverse events during labor analgesia, and improve satisfaction rate of parterients. |
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