音乐疗法在无痛分娩中对母婴的影响OACSTPCD
The effect of music therapy on mother and infant in painless delivery
目的 探索音乐疗法对无痛分娩母婴的影响.方法 选择行无痛分娩产妇120例,采用随机数字表法,将所有产妇分成两组,每组60例:非音乐疗法组(对照组)与音乐疗法组(试验组).记录产妇年龄、体重、身高、孕周及新生儿体重,硬膜外穿刺间隙与麻醉1 h后平面;分别于动脉穿刺后(T1)、胎儿娩出后(T2)和胎儿娩出后2 h(T3)记录平均动脉压(MAP)、心率(HR)、焦虑自评量表(SAS)评分;于T1、T2、T3时刻分别抽产妇动脉血5 mL检测白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)、皮质醇、血清强啡肽(DYN)水平;胎儿娩出后抽取脐动脉血行血气分析及阿氏评分(Apgar);记录产后2 h子宫出血量、总产程时间;分别观察两组产后12、24、72 h的视觉模拟评分法(VAS)评分.结果 两组产妇在年龄、体重、身高、孕周及新生儿体重、硬膜外穿刺间隙、麻醉1 h后平面、总产程时间、T1时刻(MAP、HR、SAS评分、IL-1 β、IL-6、TNF-α、皮质醇、血清DYN水平)组间差异无统计学意义(均P>0.05).试验组T2、T3时刻MAP、HR、SAS评分、IL-1β、IL-6、TNF-α、皮质醇的检测水平均低于对照组,差异均有统计学意义(均P<0.05);试验组血清DYN水平、Apgar评分、pH值、PO2高于对照组,差异均有统计学意义(P<0.05);PCO2值、子宫出血量及产后12、24、72 h VAS评分低于对照组,差异均有统计学意义(均P<0.05).结论 音乐疗法应用于无痛分娩,能帮助稳定孕产妇生命体征,缓解焦虑情绪,减轻应激反应的发生;使血清DYN水平增加,相对减少机体的炎性疼痛介质表达,并减轻孕产妇产后的疼痛感.提高新生儿Apgar评分,减少缺氧酸中毒的发生,降低孕产妇产后出血量.
Objective To investigate the influence of music therapy on maternal and neonatal outcomes during epidural analgesia in labor.Methods A total of 120 parturients undergoing epidural analgesia during labor were random-ly assigned into two groups using a random number table:the non-music therapy group(control group)and the music therapy group(experimental group),with 60 participants in each group.Maternal age,weight,height,gestational weeks,newborn weight,as well as epidural puncture interval and the level of anesthesia 1 hour postoperatively were recor-ded.Mean arterial pressure(MAP),heart rate(HR),and Self-Rating Anxiety Scale(SAS)scores were recorded at arterial puncture(T1),after fetal delivery(T2),and 2 hours after fetal delivery(T3).Arterial blood(5 mL)was drawn from parturients at T1,T2,and T3 for the measurement of interleukin(IL)-1 β,IL-6,tumor necrosis factor-α(TNF-α),cortisol,and serum dynorphin(DYN)levels.Umbilical arterial blood gas analysis and Apgar scores were obtained after fetal delivery.Uterine bleeding volume at 2 hours postpartum,total labor duration,and visual analog scale(VAS)scores at 12,24,and 72 hours postpartum were also observed.Results There were no significant differences between the two groups in maternal age,weight,height,gestational weeks,newborn weight,epidural puncture interval,anesthesia level 1 hour postoperatively,total labor duration,and T1 values(MAP,HR,SAS scores,IL-1 β,IL-6,TNF-α,cortisol,and serum DYN levels)(all P>0.05).At T2 and T3,the music therapy group exhibited lower levels of MAP,HR,SAS scores,IL-1 β,IL-6,TNF-α,cortisol(all P<0.05),higher levels of serum DYN,Apgar scores,pH,and PO2(all P<0.05),and lower levels of PCO2,uterine bleeding volume,and VAS scores at 12,24,and 72 hours postpartum(all P<0.05)compared to the control group.Conclusion The application of music therapy during epidural analgesia in labor can help stabilize vital signs,alleviate anxiety,and reduce stress responses in parturients.It increases serum DYN levels,relatively decreases the expression of inflammatory pain mediators,and alleviates postpartum pain in parturients.Moreover,it improves Apgar scores in newborns,reduces the occurrence of hypoxic acidosis,and de-creases postpartum bleeding volume.
代亚;谭红保;宋桂林;彭毅梅;赵倩
长沙市第四医院麻醉科(湖南长沙 410219)长沙市第四医院耳鼻咽喉头颈科(湖南长沙 410219)
临床医学
母婴无痛分娩音乐疗法
mother and infantpainless deliverymusic therapy
《广东医学》 2024 (002)
254-259 / 6
湖南省教育厅科学研究优秀青年项目课题(20B360);湖南省教育厅科学研究重点项目课题(20A297)
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