| 张欣,范建军,王杰,等.硬膜外分娩镇痛对妊娠期高血压疾病产妇应激反应及肾功能的影响[J].安徽医药,2022,26(2):330-333. |
| 硬膜外分娩镇痛对妊娠期高血压疾病产妇应激反应及肾功能的影响 |
| Effect of epidural labor analgesia on stress response and renal function in pregnant women with pregnancy-induced hypertension |
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| DOI：10.3969/j.issn.1009-6469.2022.02.029 |
| 中文关键词: 镇痛，产科 镇痛，硬膜外 妊娠期高血压疾病 应激反应 血清胱抑素 C |
| 英文关键词: Analgesia,obstetrical Analgesia,epidural Pregnancy-induced hypertension Stress response Serum cystatin C |
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| 中文摘要: |
| 目的评价硬膜外分娩镇痛对妊娠期高血压疾病产妇应激反应及肾功能的影响。方法选择 2018年 7月至 2019年 7月在包钢集团第三职工医院经阴道分娩的妊娠期高血压疾病产妇 80例，美国麻醉医师协会( ASA)分级 Ⅰ或Ⅱ级，年龄范围为 22~35岁，初产；足月；单胎，头位。采用随机数字表法将病人分为妊娠期高血压疾病未行任何分娩镇痛组(对照组)和妊娠期高血压疾病行硬膜外分娩镇痛组(观察组)每组 40例。记录产妇宫口开至 2 cm(T1)、 4 cm(T2)、 10 cm(T3)时的平均动脉压、心率及视觉模拟( VAS)评分；记录新生儿出生，后 1 min、5 min时的 Apgar评分；记录产妇宫口开至 2 cm、10 cm及胎儿娩出后(T4)的血糖浓度和皮质醇水平；记录产妇产前(T5)和产后(T6)肌酐、尿素、尿酸及血清胱抑素 C的水平。结果产妇宫口开至 4和 10 cm时观察组平均动脉压［( 94.09±8.43)mmHg比( 106.35±8.88)mmHg和( 103.42±10.84)mmHg比( 108.01±9.02)mmHg］、心率［( 82.18±9.16)次 /分比( 86.70±8.64)次 /分和( 87.07±7.55)次 /分比( 91.20±8.55)次 /分］及 VAS评分［( 1.24±1.21)分比( 8.80± |
| 英文摘要: |
| Objective To evaluate the effects of epidural labor analgesia on stress response and renal function in patients with hyper.tensive disorder complicating pregnancy.Methods Eighty women with gestational hypertension syndrome who underwent vaginal de.livery in The Third Staff Hospital of Baotou Steel Group from July 2018 to July 2019 were selected. The American Society of Anesthesiol.ogists (ASA) grade Ⅰ or Ⅱ, age 22-35 years old, primiparous, full-term, single birth, head position. Patients were assigned into 2 groups (n=40): no analgesia pregnancy with hypertensive group (observation group) and pregnancy-induced hypertension epidural labor analge.sia group (control group). The mean arterial pressure, heart rate and VAS scores at 2 cm (T1), 4 cm (T2), and 10 cm (T3) were recorded.The Apgar scores at 1 min and 5 min after birth were recorded. The maternal cervix was opened to 2 cm, 10 cm, and the blood glucoseconcentration and cortisol level after fetal delivery (T4), the levels of creatinine, urea, uric acid and serum cystatin C in maternal prena.tal (T5) and postpartum (T6) were recorded.Results The mean arterial pressure [(94.09±8.43) mmHg vs. (106.35±8.88) mmHg and (103.42±10.84) mmHg vs. (108.01±9.02) mmHg], heart rate [(82.18±9.16) times/min vs. (86.70±8.64) times/min and (87.07±7.55) times/ min vs. (91.20±8.55) times/min] and VAS scores [(1.24±1.21) scores vs. (8.80±0.90) scores and (5.98±2.30) scores vs. (9.56±0.22)scores] of control group were lower than those of observation group when the mother's cervix was opened to 4 and 10 cm (P<0.05). The blood glucose concentration and cortisol level in the control group were lower than those in the observation group (P<0.05). The postpar.tum serum cystatin C level in observation group was higher than that in prenatal period, while the postpartum serum cystatin C level incontrol group was lower than that in prenatal period (P<0.05).Conclusion Epidural labor analgesia can reduce the pain score duringchildbirth, reduce the stress response during the delivery of hypertensive disorder complicating pregnancy, and have less influence oncirculation and renal function, which can improve the safety of pregnant women with pregnancy-induced hypertension during delivery. |
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