临产后实施分娩镇痛对子痫前期患者妊娠结局的影响

目的:观察子痫前期患者临产后实施分娩镇痛的临床效果。方法：选择自愿接受分娩镇痛的单胎头位的子痫前期产妇60例，随机分为对照组和观察组各30例。对照组产妇在宫口≥3 cm产程进入活跃期实施硬膜外分娩镇痛；观察组产妇临产后即实施硬膜外置管，待产妇感觉疼痛不能耐受时给予镇痛药物，进行分娩镇痛。观察两组产妇的生命体征、疼痛评分、产程时间、分娩结局和围产儿结局。结果：观察组产妇第一产程潜伏期不同时点VAS 评分明显低于A组，差异有统计学意义(P<0.001)；两组产妇第一、第二产程时间比较无统计学差异(P>0.05)；观察组产妇产程中各时点平均动脉压均低于对照组，差异有统计学意义(P<0.05)；两组产妇分娩结局比较无统计学差异（P>0.05），两组产妇围产儿结局无统计学差异(P>0.05)，且两组产妇均未发生产时子痫。结论:子痫前期患者临产后实施分娩镇痛可缓解产痛，维持患者的循环稳定，在不影响分娩结局的情况下，避免产时子痫的发生，对母婴的安全起到保护作用。

Influence of look-ahead epidural catheterization on delivery outcome for puerpera with preeclampsia

Objective: To observe the clinical effect of look-ahead epidural catheterization for farrowing interval puerperae with preeclampsia.Methods: 60 cases of single birth and head-position primiparas in preeclampsia who were willing to accept the labor anesthesia were divided into observation group and control group. (30 cases in each group). The primiparas of control group was performed to labor anesthesia with epidural catheterization in active phase when cervix was up to 3cm, while it was performed after labor and administration when pain was felt in observation group. The vital signs, labor time, pain occurrence, delivery outcome and perinatal fetus outcome were recorded in different time points in 2 groups. Results: The score of VAS on various points in time during the incubation period of first stage in observation group was obviously lower, and the difference was statistically significant (P<0.001); There was no significant difference in the first and second labor time between two groups (P>0.05).The arterial pressure in observation was lower than control group at all time (P<0.05).But both two groups showed that the delivery outcome had no obvious difference.（P>0.05）. There was no significant difference in the outcome of parturition in observation group (P＞0.05). in addition, the disease of the eclampsia didn't occur among these two groups.Conclusion: It is efficacious that relief throe via labor analgesia with look-ahead of epidural catheterization, so as to maintain the patient’s circulatory stability, prevent the disease of the eclampsia during labor without affecting the outcome of delivery. This therapy can protect the safety of mother and infant.