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目的探讨硬膜外自控分娩镇痛对妊娠期高血压疾病产妇血压的影响。方法选择无麻醉禁忌证、无经阴道分娩禁忌的足月合并妊娠期高血压疾病的初产妇60例,随机分为两组,镇痛组(Z组)采用0.12%罗哌卡因+0.5μg/ml舒芬太尼自控硬膜外镇痛(PCEA);对照组(D组)为同期未实行分娩镇痛。两组分别于硬膜外阻滞前及阻滞后30min抽取母体静脉血,测定血浆一氧化氮(NO)和内皮素(ET)的浓度。比较两组产妇分娩过程中及NO和ET的浓度。结果 Z组镇痛后血压明显低于镇痛前;Z组镇痛后血压明显低于D组;Z组镇痛后血浆NO水平均显著升高,ET水平明显降低(P均<0.05)。结论硬膜外自控分娩镇痛能有效控制妊娠期高血压疾病产妇的血压,有利于母婴安全。
Objective To investigate the effect of epidural self-controlled labor analgesia on maternal blood pressure in hypertensive disorder complicating pregnancy. Methods Sixty primipara of full-term pregnancy-induced hypertensive disorder without contraindication of vaginal delivery were randomly divided into two groups. The analgesic group (Z group) was treated with 0.12% ropivacaine + 0.5μg / ml sufentanil-controlled epidural analgesia (PCEA); control group (D) did not perform labor analgesia over the same period. Maternal venous blood was drawn before epidural block and at 30 minutes after block, respectively. Plasma concentrations of nitric oxide (NO) and endothelin (ET) were measured. The concentrations of NO and ET in the two groups during delivery were compared. Results The blood pressure of group Z was significantly lower than that of group before analgesia. The blood pressure of group Z was lower than group D after analgesia. The level of NO was significantly increased and the level of ET was significantly decreased in group Z (all P <0.05). Conclusion Epidural labor-controlled labor analgesia can effectively control the blood pressure of pregnant women with hypertensive disorders during pregnancy, which is in favor of maternal and infant safety.