论文部分内容阅读
目的探讨腰硬联合麻醉分娩镇痛(combined spinal-epidural analgesia,CSEA)对妊娠期糖尿病(gestational diabetes mellitus,GDM)母儿结局的影响。方法 2011年1-12月广州市妇女儿童医疗中心,选择已确诊GDM初产妇185例观察母儿结局,其中使用CSEA的93例为研究组;不使用CSEA的92例为对照组。结果活跃期2小时及3小时末梢血糖值比较,研究组明显低于对照组(P<0.05);且研究组活跃期的血糖相对平稳;活跃期末两组孕妇血清皮质醇水平比较,研究组明显低于对照组(P<0.05)。研究组脐血皮质醇水平明显低于对照组(P<0.05);研究组新生儿血糖明显高于对照组(P<0.05);研究组活跃期时间较对照组明显缩短(P<0.05);研究组剖宫产率明显低于对照组。结论腰硬联合麻醉分娩镇痛可能缩短GDM产妇的活跃期产程,可以减轻GDM产妇在分娩过程中内分泌的改变,改善新生儿血糖,降低剖宫产率,对母儿结局无不良影响。
Objective To investigate the effect of combined spinal-epidural analgesia (CSEA) on the maternal and neonatal outcome of gestational diabetes mellitus (GDM). Methods From January to December 2011, Guangzhou Women and Children Medical Center chose 185 confirmed cases of GDM primiparaea, of which 93 cases were using CSEA as the study group and 92 cases without CSEA as the control group. Results Compared with the control group (P <0.05), the blood sugar level in the study group was relatively stable at 2 hours and 3 hours. The level of serum cortisol in the two groups at the end of active phase was significantly higher in the study group than in the control group Lower than the control group (P <0.05). The cord blood cortisol level in the study group was significantly lower than that in the control group (P <0.05). The neonatal blood glucose in the study group was significantly higher than that in the control group (P <0.05). The active phase of the study group was significantly shorter than that of the control group (P <0.05) Study group cesarean section rate was significantly lower than the control group. Conclusion Combined spinal anesthesia and labor analgesia may shorten the active labor course of GDM maternal women, reduce the endocrine changes of GDM maternal during delivery, improve neonatal blood glucose, reduce the rate of cesarean section and have no adverse effect on the outcome of maternal and child.