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目的研究可行走的蛛网膜下腔一硬膜外联合(CSEA)分娩镇痛对胎盘一胎儿内分泌功能的影响。方法选择初产妇60例,随机分为A组(30例)和B组(30例),A组无任何镇痛措施,B组采用CSEA镇痛,检测两组产妇外周血各时点、脐血、羊水中的CRH、雌/孕激素、PGE2、皮质醇。结果两组产妇间外周血各时点、脐血、羊水中的雌/孕激素水平利CRH、PGE2、皮质醇浓度的差异均无显著性,P>0.05。结论CSEA方法应用于分娩镇痛在提供满意的镇痛效果的同时没有影响胎盘一胎儿的内分泌功能,并降低了产妇的应激反应,对分娩的影响少,是一个安全可靠的镇痛方法。
Objective To investigate the effect of walking subarachnoid-epidural (CSEA) labor analgesia on the placental endocrine function of a fetus. Methods A total of 60 primipara patients were randomly divided into group A (30 cases) and group B (30 cases). Group A received no analgesic measures. Group B received CSEA analgesia. Blood, amniotic fluid CRH, estrogen / progestin, PGE2, cortisol. Results The levels of estrogen / progesterone, CRH, PGE2 and cortisol in peripheral blood of the two groups were not significantly different at all time points, umbilical cord blood and amniotic fluid (P> 0.05). Conclusions CSEA is a reliable and safe method for analgesia in labor while providing satisfactory analgesic effect without affecting the endocrine function of the placenta in a fetus and reducing the stress response of the mother with little impact on childbirth.