妊娠期糖尿病产程中应用分娩镇痛对母婴的影响

发布时间：2018-01-05 18:03

本文关键词：妊娠期糖尿病产程中应用分娩镇痛对母婴的影响　出处：《中国医学工程》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨妊娠期糖尿病(GDM)产程中应用硬膜外麻醉、蛛网膜下腔麻醉联合脊椎麻醉(腰-硬联合麻醉,CSEA)分娩镇痛对母婴的影响。方法将该院2013年11月-2015年4月GDM初产妇62例纳为研究对象,将其分为观察组和对照组,每组患者各31例,观察组患者给予CSEA分娩镇痛,对照组患者采用常规镇痛方式(非药物性镇痛法或者笑气)。结果观察组患者活跃期平均持续时间较对照组患者短(P0.05);两组患者平均潜伏期时间、第二产程平均持续时间比较差异均无统计学意义(P0.05);观察组患者活跃期的末梢血糖水平处于相对稳定状态,且活跃期各个时间点的末梢血糖值均低于对照组患者(P0.05);观察组患者活跃期T4时静脉血皮质醇(Cor)较对照组低(P0.05);观察组新生儿脐带血Cor较对照组低(P0.05);观察组新生儿血糖水平较对照组高(P0.05);两组新生儿Apgar评分比较差异无统计学意义(P0.05)。结论在妊娠期糖尿病产妇产程中应用分娩镇痛,可有效缩短活跃期时间,控制血糖及皮质醇水平稳定,改善新生儿血糖,可获得良好的母婴结局。
[Abstract]:Objective to investigate the gestational diabetes mellitus (GDM) application in labor epidural anesthesia, subarachnoid anesthesia combined with spinal anesthesia (CSEA, CSEA) effect of labor analgesia on maternal and infant. Methods the hospital in November 2013 April -2015 GDM 62 primipara Na as the research object, divided into the observation group and the the control group, there were 31 cases in each group, the observation group was treated with CSEA analgesia, the control group were treated by routine analgesia (non drug analgesia or nitrous oxide). Results in the observation group, the average duration of active period shorter than patients in the control group (P0.05); the two groups of the average latency, average duration of the second stage of labor the time there was no statistically significant difference (P0.05); the patients in the observation group were active peripheral blood glucose level in a relatively stable state, and the active period of each time point of the peripheral blood glucose values were lower than the control group patients (P0.05); patients in the observation group The active period of T4 venous blood cortisol (Cor) is lower than the control group (P0.05); observation group of neonatal cord blood Cor was lower than that in control group (P0.05); observation group of neonatal blood glucose levels higher than the control group (P0.05); there was no significant difference between two groups of neonatal Apgar score (P0.05). Conclusion in the application of labor analgesia gestational diabetes maternal labor, can effectively shorten the active period of time, the level of blood glucose and cortisol control and stability, improve blood glucose, can obtain good maternal and neonatal outcomes.

【作者单位】：广东省五华县中医医院妇产科;
【分类号】：R714.256
【正文快照】： 产妇围生期分娩镇痛应受到临床高度关注,目前硬膜外麻醉、蛛网膜下腔麻醉联合脊椎麻醉(腰-硬联合麻醉,combined spinal-epidural analgesia,CSEA)分娩镇痛效果值得信赖,并且在临床的应用逐渐广泛深入。然而目前国内外还鲜少有报道涉及CSEA对各种妊娠合并症的影响[1]。妊娠期糖

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