低频神经和肌肉刺激仪在分娩镇痛中的应用价值及其对母儿的影响

目的探讨低频神经和肌肉刺激仪在分娩镇痛中的应用价值及其对母儿的影响。方法选择2013年5月至2015年2月在武汉市第五医院住院并自然临产的120例产妇的临床资料,根据患者治疗意愿分为低频神经和肌肉刺激仪组(A组)、椎管内麻醉组(B组)和对照组,每组40例。比较3组产妇各产程时间、各产程疼痛程度、分娩方式、新生儿Apgar评分及产后并发症。结果 A、B两组产妇第一、二产程及总产程时间[(6.12±2.04)h、(38.72±15.14)min、(6.85±2.10)h;(8.07±2.48)h、(51.92±19.77)min、(9.11±2.52)h]均短于对照组[(10.02±2.53)h、(85.21±21.32)min、(11.65±2.67)h](P0.05),且A组产妇第一、二产程及总产程时间明显短于B组(P0.05);A、B两组产妇第一、二、三产程疼痛程度评分[(3.9±1.5)分、(4.8±2.4)分、(5.4±2.7)分;(3.8±1.6)分、(4.7±2.2)分、(5.2±2.5)分]明显低于对照组[(5.7±2.2)分、(7.4±2.6)分、(9.0±2.8)分](P0.05);A组产妇阴道顺产率(55.0%)明显高于B组(40.0%)及对照组(42.5%)(P0.05);阴道助产率(15.0%)明显低于B组(27.5%)(P0.05),而剖宫产率(30.0%)明显低于对照组(42.5%)(P0.05);A、B两组产后2 h出血量[(127.5±45.4)m L、(211.2±57.8)m L]明显低于对照组[(276.4±64.1)m L](P0.05),且A组产后2 h出血量也明显低于B组(P0.05)。结论低频神经和肌肉刺激仪分娩镇痛效果与椎管内麻醉相似,但可明显缩短产程时间,减少产后2 h出血量,提高阴道顺产率,且对母儿安全可靠。

The value of low - frequency nerve and muscle stimulator in the labor analgesia and the effect on mother and child

Objective To study the value of low - frequency nerve and muscle stimulator in the labor analgesia and its effect on the mother and child. Methods Clinical data of 120 cases of puerpera treated from May 2013 to February 2015 in NO. 5 Hospital of Wuhan were chosen. According to their respective treatment will, they were divided into low - frequency nerve and muscle stimulator group (group A), spinal canal anesthesia group (group B) and control group,with 40 cases in each group. The labor time, the degree of labor pain, delivery mode, neonatal Apgar score and postpartum complications of three groups were compared. Results The first, second maternal labor and total labor time of group A and group B [(6. 12 ± 2. 04) h、(38. 72 ± 15. 14) min、(6. 85 ± 2. 10) h vs.(8. 07 ±2. 48) h、(51. 92 ±19. 77) min、(9. 11 ±2. 52) h] were shorter than those of the control group [(10. 02 ±2. 53) h、(85. 21 ±21. 32) min、(11. 65 ±2. 67) h] (P <0. 05), and the first, second maternal labor and total labor time of group A [(6. 12 ±2. 04) h、(38. 72 ±15. 14) min、(6. 85 ±2. 10) h] was significantly shorter than that of the group B [(8. 07 ±2. 48) h、(51. 92 ±19. 77) min、(9. 11 ±2. 52) h] (P <0. 05). The stages of pain of first, second and third maternal labor of group A and group B [(3. 9 ±1. 5)、(4. 8 ±2. 4)、(5. 4 ±2. 7) vs. (3. 8 ±1. 6)、(4. 7 ±2. 2)、(5. 2 ±2. 5)] were significantly lighter than that of control group[(5. 7 ± 2. 2)、(7. 4 ±2. 6)、(9. 0 ±2. 8)] (P < 0. 05). The vaginal normal delivery rate of group A (55. 0 %) was obviously higher than those of group B (40. 0 %) and control group(42. 5 %)(P <0. 05),and vaginal subsidiary production rate(15. 0 %) was lower than that of group B (27. 5 %)(P <0. 05), while cesarean delivery rate (30. 0 %) was significantly lower than that of control group(42. 5 %)(P <0. 05). The 2 hours postpartum bleeding of group A and group B [(127. 5 ±45. 4) mL、(211. 2 ±57. 8) mL] were obvious lower than that of control group[(276. 4 ± 64. 1) mL] (P < 0. 05), and group A [(127. 5 ± 45. 4) mL]was obviously lower than group B [(211. 2 ±57. 8) mL] (P <0. 05). Conclusion The labor analgesia effect of low - frequency nerve and muscle stimulator are similar with spinal canal anesthesia, but can obviously shorten labor time, reduce 2 hours postpartum bleeding, improve the vagina naturally production rate, and safe and reliable to mother and child.