Abstract：【Objective】 To analyze the effect of analgesia mode during childbirth on stress status, immune function and pregnancy outcome. 【Methods】 A total of 164 pregnant women were randomly divided into two group according to the different ways of labor analgesia. The control group was given the analgesic measures of epidural delivery, and the observation group was given a combination of lumbar and hard epidural anesthesia for labor analgesia. The analgesic effect, postpartum stress, immune function before and after delivery and pregnancy outcome were compared and analyzed in the two groups. 【Results】 The total analgesic rate of the observation group was 87.80% (72/82), which was significantly higher than that of the control group, which was 69.51% (57/82) (P<0.05). The anxiety self-rating scale (SAS) score and depression self-rating scale (SDS) score of the observation group were all lower than those of the control group, which showed the incidence of anxiety and depression were lower than those of the control group (P<0.05). There was no significant difference in the level of immune function between the two groups (P>0.05). After delivery, levels of CD4+, CD8+, and CD4+/CD8+ in the two groups decreased, while IL-6 increased (P<0.05). The levels of CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, however, the levels of CD8+ and IL-6 were lower than those in control group (P<0.05). The cesarean section rate in the observation group was 6.10%, which was significantly lower than that in the control group (20.73%) (P<0.05). The incidence of total adverse reactions in the observation group was significantly lower than the control group (P<0.05). 【Conclusion】 Combined spinal epidural anesthesia for labor analgesia can significantly improve the analgesic effect, improve postpartum stress and immune function, and improve safety.
[1] 孙伟杰,曲元. 我国分娩镇痛现状和亟待解决的问题[J]. 中国实用妇科与产科杂志,2015,31(02):116-120. [2] 张望平,祝胜美. 左布比卡因复合舒芬太尼硬膜外分娩镇痛的临床应用[J]. 中国妇幼保健,2013,28(24):4062-4064. [3] 贾瑞喆,樊晟,袁红梅,等. 椎管内分娩镇痛致阴道分娩产时发热的临床分析[J]. 实用妇产科杂志,2015,31(09):662-664. [4] 王金印. 舒芬太尼与罗哌卡因联合分娩镇痛对产程进展和剖宫产率的影响[J]. 中国妇幼保健,2014,29(16):2627-2628. [5] 朱红霞,姚远,武永生,等. 小剂量芬氟合剂穴位注射用于分娩镇痛及对产妇应激激素水平的影响[J]. 中国针灸,2013,33(04):342-346. [6] Simarro M, Espinosa JA, Salinas C, et al. A prospective randomized trial of postural changes vs passive supine lying during the second stage of labor under epidural analgesia[J]. Med Sci (Basel). 2017 ;5(1). pii: E5. [7] Sitras V, altytre Benth J, Eberhard-Gran M. Obstetric and psychological characteristics of women choosing epidural analgesia during labour: a cohort study[J]. PLoS One. 2017;12(10):e0186564. [8] 沈婷,郑静. 序贯法测定罗哌卡因复合舒芬太尼硬膜外分娩镇痛的最小有效浓度[J]. 上海交通大学学报(医学版),2016,36(02):252-255. [9] Vedagiri Sai R, Singh SI, Qasem F, et al. Onset of labour epidural analgesia with low-dose bupivacaine and different doses of fentanyl[J]. Anaesthesia. 2017 ;72(11):1371-1378.
2018, Vol. 35 
