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哌替啶对自然分娩时子宫活动及宫颈扩张的影响(作者译)

[The influence of pethidine on uterine activity and dilatation of the cervix in spontaneous labour (author's transl)].

作者信息

Tournaire M, Catinat-Ozil D, Bréart G, Scherrer P, Baron J M, Leroy B

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1980;9(2):261-6.

PMID:7005306
Abstract

Two series of patients, randomly selected, 29 of whom had pethidine and 29 of whom had a placebo, were compared in order to study the influence of intra-muscular pethidine on uterine activity and on the speed with which the cervix dilated. The experiment was a double blind one. A significant increase in the basal tone of the uterine muscle was found 40 minutes after the injection in the group that received pethidine, although there was no other significant difference in the other parameters which were intensity, frequency, length, surface of the contractions [half the height multiplied by (X times) the base on the monitor recording], uterine activity in Montevideo and in Toulouse units and the speed of dilatation. These results do not bear out the classical hypotheses of the muscle relaxing effect of pethidine, and in particular that the uterus relaxes better between contractions, nor that there is relaxation of the cervix in labour. The indication for the use of pethidine is perhaps justified because of its analgesic effect, but as far as favouring dilatation of the cervix in labour is concerned is at best worthy of discussion.

摘要

随机选取两组患者,每组29人,一组注射哌替啶,另一组注射安慰剂,以研究肌肉注射哌替啶对子宫活动及宫颈扩张速度的影响。该实验为双盲实验。注射哌替啶的组在注射40分钟后子宫肌基础张力显著增加,不过在其他参数上没有其他显著差异,这些参数包括宫缩强度、频率、时长、面积(在监护记录上为高度的一半乘以基数)、蒙得维的亚单位和图卢兹单位的子宫活动以及扩张速度。这些结果并不支持哌替啶具有肌肉松弛作用的经典假说,尤其是子宫在宫缩间期能更好地松弛这一假说,也不支持分娩时宫颈会松弛的假说。使用哌替啶的指征或许因其镇痛作用而合理,但就促进分娩时宫颈扩张而言,充其量值得商榷。

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