文章摘要
地塞米松对硬膜外分娩镇痛产妇发热的影响
Effect of dexamethasone on the inhibition of epidural-related maternal fever
  
DOI：10.12089/jca.2021.08.009
中文关键词: 分娩镇痛  硬膜外  发热  地塞米松
英文关键词: Labor analgesia  Epidural  Fever  Dexamethasone
基金项目:四川省卫生和计划生育委员会科技项目（17PJ239）；成都市卫生和计划生育委员会科技项目（2018092）
作者单位E-mail
卢冬梅 610045,成都市,四川省妇幼保健院麻醉科  
龙焱 常州市中医院麻醉科  
周龑 610045,成都市,四川省妇幼保健院麻醉科  
朱思颖 610045,成都市,四川省妇幼保健院麻醉科  
张丹 610045,成都市,四川省妇幼保健院妇女保健科  
张健 610045,成都市,四川省妇幼保健院麻醉科 anesthesiology@zju.edu.cn 
摘要点击次数: 1712
全文下载次数: 738
中文摘要:
      
目的 探索硬膜外给予地塞米松对硬膜外分娩镇痛后产妇发热的影响。
方法 选择实施分娩镇痛的单胎足月初产妇200例，年龄22～38岁，BMI 20～35 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将产妇分为两组：地塞米松组（D组）和对照组（C组），每组100例。两组均采用程控硬膜外间歇脉冲给药的方式实施分娩镇痛，D组在给予硬膜外首次剂量（0.08%罗哌卡因+舒芬太尼0.4 μg/ml，共12 ml）后，经硬膜外给予地塞米松10 mg（2 ml）；C组在给予相同硬膜外首次剂量后经硬膜外给予生理盐水2 ml。测量并记录分娩镇痛开始前、分娩镇痛开始后1、2、3、4、5 h和胎儿娩出时产妇鼓膜温度。记录分娩镇痛开始前、分娩镇痛开始后1、2、3、4、5 h和第一产程结束时的Bromage评分、VAS疼痛评分。记录产间发热例数、分娩转剖宫产例数，记录镇痛时间、产程时间、新生儿出生后1、5、10 min Apgar评分，记录其他不良反应的发生情况。
结果 D组发热率明显低于C组（P<0.05）。两组分娩转剖率、镇痛时间、产程时间、新生儿出生后1、5、10 min Apgar评分和各时点VAS疼痛评分差异无统计学意义，两组均未发生下肢运动神经阻滞及其他不良反应。
结论 镇痛初始经硬膜外给予地塞米松10 mg能明显降低产妇硬膜外分娩镇痛后发热率，且不影响母婴安全。
英文摘要:
      
Objective Explore the effect of epidural administration of dexamethasone on epidural-related maternal fever.
Methods A total of 200 nulliparous primiparas, aged 22-38 years, BMI 20-35 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups: group D and group C, 100 patients in each group. Epidural labor analgesia was performed in both groups. Group D was given dexamethasone 10 mg epidurally after an initial dose (12 ml of 0.08% ropivacaine + sufentanil 0.4 μg/ml). While Group C was given 2 ml of normal saline instead of dexamethasone after the same initial dose. The temperature of maternal tympanic membrane was measured and recorded before laboranalgesia, 1, 2, 3, 4, 5 hours after labor analgesia and after the fetus was delivered. Bromage score and VAS pain score were recorded before labor analgesia, 1, 2, 3, 4, 5 hours after labor analgesia and at the end of the first labor stage. The number of fever cases and cesaren section cases were recorded. Duration of labor analgesia, labor time, Apgar score of 1, 5, 10 minutes after delivery and other adverse events were also recorded.
Results The incidence of maternal fever in group C was significantly lower in group D. There was no significant difference in the rate of cesarean section, the duration of analgesia, labor time and the VAS score,Apgar score of 1, 5, 10 minutes after delivery between the two groups. There was no motor nerve block and other adverse events occurred in the two groups.
Conclusion A single use of dexamethasone 10 mg at the beginning of epidural analgesia could reduce epidural-related maternal fever significantly and it is safe to newborns.
查看全文   查看/发表评论  下载PDF阅读器
关闭