Department of Anesthesiology, Chifeng Obstetrics and Gynecology Hospital, Chifeng 024000, Inner Mongolia, China.
Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia, China.
J Healthc Eng. 2021 Nov 25;2021:2879678. doi: 10.1155/2021/2879678. eCollection 2021.
This paper aimed to analyze the analgesic effects of continuous epidural labor analgesia (ELA) at different periods and its effects on postpartum depression, maternal and infant outcomes, and maternal blood pressure. Giving birth in our hospital from September 2017 to August 2019, 119 primiparas with spontaneous delivery were enrolled and divided into an observation group (65 cases) and a control group (54 cases). Patients in the observation group received epidural block analgesia in advance, whereas those in the control group received epidural block analgesia routinely. At 25 days after delivery, breast milk samples were collected, in which miRNA-146b level was detected by PCR. The patients were compared between the two groups with respect to progress of labor, analgesic effects during 3 stages of labor, labor outcomes, adverse reactions, and levels of NO, ANP, and ET-1 in the parturients' umbilical artery blood. Compared with those in the control group, patients in the observation group had a remarkably higher miRNA-146b level in the breast milk ( < 0.05), remarkably lower average Visual Analogue Scale (VAS) scores during the active phase and the second stage of labor ( < 0.05), and remarkably higher levels of NO, ANP, and ET-1 ( < 0.05). There were no statistically significant differences in adverse reactions and modes of delivery between the two groups ( < 0.05). ELA starting from the latent phase can improve the miRNA-146b level in maternal breast milk, alleviate labor pain of parturients, and shorten stages of labor. Therefore, our study is worthy of clinical promotion. We still need to do more experiments and use more data to conclude more scientific results in future research work.
本研究旨在分析不同时期连续硬膜外分娩镇痛（ELA）的镇痛效果及其对产后抑郁、母婴结局和产妇血压的影响。选择 2017 年 9 月至 2019 年 8 月在我院分娩的初产妇 119 例，随机分为观察组（65 例）和对照组（54 例）。观察组产妇提前进行硬膜外阻滞镇痛，对照组产妇常规进行硬膜外阻滞镇痛。产后 25 天采集产妇母乳标本，采用 PCR 法检测 miRNA-146b 水平。比较两组产妇产程进展、各产程镇痛效果、分娩结局、不良反应及产妇脐动脉血中 NO、ANP、ET-1 水平。与对照组比较，观察组产妇母乳中 miRNA-146b 水平明显升高（ < 0.05），活跃期和第二产程的平均视觉模拟评分（VAS）明显降低（ < 0.05），NO、ANP、ET-1 水平明显升高（ < 0.05）。两组不良反应及分娩方式比较差异无统计学意义（ < 0.05）。潜伏期开始 ELA 能提高产妇母乳中 miRNA-146b 水平，减轻产妇分娩疼痛，缩短产程。因此，本研究值得临床推广。在未来的研究工作中，我们仍需要进行更多的实验并使用更多的数据来得出更科学的结论。
