国际妇产科学杂志

国际妇产科学杂志 ›› 2013, Vol. 40 ›› Issue (6): 507-509.

• 论著 • 上一篇    下一篇

分娩镇痛对妊娠期糖尿病产程、产时内分泌及新生儿血糖的影响

蒋艳敏 , 何 平, 刘慧姝, 赖毓冕, 秦 爽   

  1. 510623 广州市妇女儿童医疗中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-12-15 发布日期:2013-12-15
  • 通讯作者: 刘慧姝

The Effect of Combined-epidural Labor Analgesia on Stages of Labor Intrapartum Endocrine and Neonate Blood Sugar in Gestational Diabetes Mellitus

JIANG Yan-min，HE Ping，LIU Hui-shu，LAI Yu-mian，QIN Shuang   

  1. Guangzhou Women and Children′s Medical Center，Guangzhou 510623，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-12-15 Online:2013-12-15
  • Contact: LIU Hui-shu

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摘要： 目的：探讨腰麻-硬膜外联合阻滞麻醉（CSEA）分娩镇痛对妊娠期糖尿病（GDM）产程、产时血糖、皮质醇及新生儿血糖的影响。方法：已确诊为GDM并行CSEA分娩镇痛的48例初产妇为试验组；已确诊为GDM但未使用CSEA分娩镇痛的45例初产妇为对照组。监测2组产程、产时血糖和皮质醇水平，以及脐血皮质醇及新生儿血糖水平。结果：①活跃期1，2，3 h末梢血糖值比较试验组低于对照组（均P＜0.05）；且试验组活跃期的血糖相对平稳；活跃期末试验组血清皮质醇水平低于对照组（P＜0.05）。②试验组脐血皮质醇水平低于对照组，试验组新生儿血糖高于对照组（均P＜0.05）。③试验组活跃期时间较对照组缩短（P＜0.05）。结论：CSEA分娩镇痛可能缩短GDM产妇的活跃期产程，减轻GDM产妇在分娩过程中血糖及皮质醇的波动，改善新生儿血糖。

关键词: 糖尿病, 妊娠, 麻醉, 硬膜外, 镇痛, 产科, 氢化可的松, 血糖

Abstract: Objective：To evaluate the effect of combined-epidural labor analgesia（CSEA） on stages of labor intrapartum blood sugar， serum cortisol and neonate blood sugar in women with gestational diabetes mellitus（GDM）. Methods：48 cases of primiparas diagnosed GDM received CSEA， and were observed as studied group and the other 45 cases without receiving CSEA were observed as control group. All the stages of labor ，intrapartum blood sugar， serum cortisol， cortisol in umbilical cord blood and neonate blood sugar were determined. Results：①The blood sugar in studied group were significantly lower than the control in the first、 second and third hours during active phase（P＜0.05） and the blood sugar in studied group is ralatively stable . The serum cortisol of the pregnant in studied group were significantly lower than the control in end of the active phase（P＜0.05）. ②The cortisol in umbilical cord blood in studied group were significantly lower than the control（P＜0.05）. The blood sugar of neonate in studied group were significantly higher than the control（P＜0.05）. ③The time of the active phase in studied group were significantly shorter than the control（P＜0.05）. Conclusions：CSEA maybe could shorten the time of the active phase and effectively eliminate the fluctuation of blood sugar and serum cortisol in gestational diabetes mellitus， and also improve blood sugar of neonate.

Key words: Diabetes, gestational, Anesthesia, epidural, Analgesia, obstetrical, Blood glucose