实用心电与临床诊疗2025，Vol.34Issue(4)：508-513,6.DOI:10.13308/j.issn.2097-5716.2025.04.006
右美托咪定PIEB在妊娠期高血压疾病产妇分娩镇痛中的应用及对脐血流、母婴结局的影响
Application of dexmedetomidine via PIEB for labor analgesia in hypertensive disorder of pregnancy parturients,and its effect on umbilical artery flow and maternal-fetal outcomes
摘要
Abstract
Objective To investigate the application of dexmedetomidine via programmed intermittent epidural bolus(PIEB)for labor analgesia in hypertensive disorder of pregnancy(HDP)parturients,and its effect on umbilical artery flow and maternal-fetal outcomes.Methods This study was a prospective,and double-blind clinical study.A hundred HDP parturients who had undergone labor analgesia were selected,and randomly divided into group A and B,each with 50 cases by random number table method.Group A received continuous epidural infusion,while group B received PIEB.Based on the visual analogue scale(VAS),the degree of pain before analgesia(T0),1 h after analgesia(T1),2 h after analgesia(T2),and at the time of complete cervical dilation(T3)were compared between the two groups of parturients.We simultaneously recorded the changes of umbilical artery flow at T0-T2[umbilical artery resistance index(RI),pulsation index(PI)and the ratio of maximum systolic blood velocity to diastolic blood velocity(S/D)],maternal vital signs at T0 andT1[heart rate(HR)and mean arterial pressure(MAP)],and the occurrence of adverse maternal-fetal outcomes and adverse reactions in the two groups.Results Comparison of VAS scores at different time points within each group showed statistically significant differences(all P＜0.01).VAS scores at T1,T2 and T3 were all lower than that at T0(all P＜0.05).VAS score of the group B at T2 was lower than that at T,(P＜0.05).VAS score of the group B at T3 was lower than that at T2(P＜0.05),while the VAS score of the group B at T2 or T3 were both lower than that of the group A(both P＜0.01).There was no statistically significant difference in VAS score between the two groups at T0 and T,(P＞0.05).Statistically significant differences were observed in RI,PI,and S/D values across different time points within both groups(all P＜0.01).At T1 and T2,the RI,PI,and S/D ratio of fetuses in both groups all decreased compared to T0(all P＜0.05).At T2,the RI,PI and S/D ratio of fetuses in both groups were all lower than those at T,(all P＜0.05).There were no statistically significant differences in fetal RI,PI,and S/D ratio between the two groups at T0,T1 or T2(all P＞0.05).At T1,HR and MAP in the two groups were both lower than those at T0(both P＜0.05),while HR and MAP of the group B were both lower than those of the group A(both P＜0.05).There were no statistically significant differences in the total incidences of adverse maternal-fetal outcomes or drug adverse reactions between the two groups(all P＞0.05).Conclusion Dexmedetomidine via PIEB could improve the effect of labor analgesia in HDP parturients,and maintain stability of fetal umbilical hemodynamics and maternal vital signs,with a high safety.关键词
妊娠期高血压疾病/分娩镇痛/右美托咪定/程控硬膜外间歇脉冲注入/脐血流Key words
hypertensive disorder of pregnancy/labor analgesia/dexmedetomidine/programmed intermittent epidural bolus/umbilical artery flow分类
医药卫生引用本文复制引用
王咏,赵勇辉,王震..右美托咪定PIEB在妊娠期高血压疾病产妇分娩镇痛中的应用及对脐血流、母婴结局的影响[J].实用心电与临床诊疗,2025,34(4):508-513,6.基金项目
河南省科技攻关计划项目(182102310536) （182102310536）
