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目的探讨硬膜外自控分娩镇痛对妊娠期高血压产妇血压的影响。方法选取无麻醉禁忌证、无经阴道分娩禁忌的足月合并妊娠期高血压的初产妇60例,随机将其分为两组,各30例,镇痛组产妇采用0.12%罗哌卡因+0.5μg/ml舒芬太尼自控硬膜外镇痛(PCEA);对照组产妇为同期未实行分娩镇痛。两组分别于硬膜外阻滞前及阻滞后30 min抽取母体静脉血,测定血浆一氧化氮(NO)和内皮素(ET)的浓度。比较两组产妇分娩过程中以及NO和ET的浓度。结果镇痛组产妇镇痛后血压明显低于镇痛前;镇痛组产妇镇痛后血压明显低于对照组;镇痛组镇痛后血浆NO水平均明显升高ET水平明显降低差异均有统计学意义(P<0.05)。结论硬膜外自控分娩镇痛能有效控制妊娠期高血压产妇的血压,有利于母婴安全。
Objective To investigate the effect of epidural self-controlled labor analgesia on blood pressure in pregnant women with hypertension. Methods A total of 60 primiparae of full-term pregnancy complicated with hypertension without contraindication of vaginal delivery were randomly divided into two groups, 30 cases in each group. The analgesic group adopted 0.12% ropivacaine + 0.5μg / ml sufentanil-controlled epidural analgesia (PCEA); control group of mothers for the same period did not implement labor analgesia. Maternal venous blood was collected before epidural block and at 30 min after block, respectively. Plasma concentrations of nitric oxide (NO) and endothelin (ET) were measured. The concentrations of NO and ET in the two groups during childbirth were compared. Results The blood pressure of the analgesic group was significantly lower than that of the analgesic group before the analgesia. The blood pressure of the analgesic group was significantly lower than that of the control group after analgesia. In the analgesic group, the plasma NO levels were significantly increased and the ET levels were significantly lower Statistical significance (P <0.05). Conclusion Epidural labor-controlled labor analgesia can effectively control the blood pressure of pregnant women with high blood pressure, which is beneficial to the safety of mother and infant.