Baidu
map

BMJ:两种分娩镇痛方法之比较

2015-02-24 赵洲 MedSci原创

硬膜外麻醉被视为最有效的分娩期镇痛方法,经常被用作镇痛的首选方法。但在局部镇痛不近便时或者产妇或产科医师希望采用低创方法时,肌肉或静脉注射阿片类药物可以作为一种代替方案。瑞芬太尼是一种有效的μ型阿片受体激动剂。较短的半衰期使得瑞芬太尼可以在产妇自控下使用以减轻分娩的痛苦。瑞芬太尼可以通过胎盘屏障,但胎儿可以迅速代谢。尽管早前已经有两个研究评价产妇对瑞芬太尼和硬膜外麻醉止痛的满意度。两种止痛方法没有



硬膜外麻醉被视为最有效的分娩期镇痛方法,经常被用作镇痛的首选方法。但在局部镇痛不近便时或者产妇或产科医师希望采用低创方法时,肌肉或静脉注射阿片类药物可以作为一种代替方案。瑞芬太尼是一种有效的μ型阿片受体激动剂。较短的半衰期使得瑞芬太尼可以在产妇自控下使用以减轻分娩的痛苦。瑞芬太尼可以通过胎盘屏障,但胎儿可以迅速代谢。尽管早前已经有两个研究评价产妇对瑞芬太尼和硬膜外麻醉止痛的满意度。两种止痛方法没有表现出差异。但这两个研究有局限性。因此,有必要对这两种止痛方法再次进行比较研究。

试验参与者是中等到高度分娩疼痛。共有1414名产妇参与此次研究,709人被随机分配到瑞芬太尼组,705被分配到硬膜外麻醉组。因为部分最终选择了剖腹产,所以最终只有1358人的数据(瑞芬太尼687人,硬膜外麻醉671人)。在709名女性中,447人(65%)在分娩时使用了瑞芬太尼,硬膜外麻醉组为347人(52%)。瑞芬太尼组用药量为30μg(20μg/mL的溶液)。这一剂量是基于早前的研究。剂量可以根据疼痛适度调整到40或20μg。分娩期间,产妇要回答两个不同的问题。产妇要用直观模拟标度尺对止痛方法进行评价,0为最不满意,100为高度满意。产妇还要回答有关疼痛评分的问题。接受止痛治疗后,产妇的血氧饱和度被持续监测。医护人员记录恶心、呕吐、瘙痒和高血压等不良反应的发生率。

研究结果表明,两种止痛方法效果并不一样。产妇对硬膜外麻醉止痛更为满意。尽管病人对自控瑞芬太尼止痛有着很高的满意度,但相比于硬膜外麻醉却不那么理想。这对临床分娩止痛的方案选择有着重要的意义。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (6)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]
    2015-08-23 柳叶一刀
  2. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]
    2015-03-02 lylis

    学习了。谢。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]
    2015-02-27 xiaoai5777

    不错的文章,学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]
    2015-02-26 linlin2312
  5. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]
    2015-02-26 zhaojie88
  6. [GetPortalCommentsPageByObjectIdResponse(id=1847655, encodeId=42da184e655a6, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Sun Aug 23 11:51:00 CST 2015, time=2015-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17388, encodeId=fa791e38894, content=学习了。谢。, beContent=null, objectType=article, channel=null, level=null, likeNumber=159, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=764f1616389, createdName=lylis, createdTime=Mon Mar 02 21:10:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17088, encodeId=b1141e0880c, content=不错的文章,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 15:30:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1275054, encodeId=a25712e505426, content=<a href='/topic/show?id=263031541b4' target=_blank style='color:#2F92EE;'>#分娩#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31541, encryptionId=263031541b4, topicName=分娩)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355208, encodeId=241a1355208c1, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96799, encryptionId=256a96e9990, topicName=镇痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603814, encodeId=418d16038142f, content=<a href='/topic/show?id=e2773155898' target=_blank style='color:#2F92EE;'>#分娩镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31558, encryptionId=e2773155898, topicName=分娩镇痛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=146919086692, createdName=zhangbaojun, createdTime=Thu Feb 26 12:51:00 CST 2015, time=2015-02-26, status=1, ipAttribution=)]

相关资讯

Lancet:妊娠与分娩时,为何母亲心理健康如此重要?

最近,《柳叶刀》(Lancet)杂志发表了一系列论文,强调了妊娠期间和分娩后母亲心理健康的重要性。 在高收入国家,超过10%的女性在产前和产后会遇到心理健康问题。 这些论文虽未统计中低收入国家的情况,但研究者预计这一比例可能更高。 产前心理问题的风险因素 第一项研究评估了产前抑郁、焦虑、饮食问题和创伤后应激障碍(PTSD)。 研究者指出,虽然该研究主要关注的是产前

分手之痛vs分娩之痛,谁更痛?

可能引发疼痛的伤害性刺激是客观的,但是疼痛本身却完全是主观的。疼痛无法直接测量,与其他很多分级标准尽量以客观可定量的指标为依据不同,自我报告人类疼痛分级的“金标准”,也附以疼痛对于人情绪和行为的影响表现。 目前有关疼痛分级标准基本大同小异,疼痛强度分为3等0到10级。 0级:无疼痛。感觉完全正常。 轻度疼痛: 不影响大多数活动。心理上能够适应,不需要用药物或设备就可以自行缓解。 1级

AJOG:事与愿违的分娩方式或致产后抑郁

产后抑郁约发生在15%的产妇中,发生率不低,却很容易漏诊。近日Houston KA等人对一项关于分娩方式偏好的纵向研究数据行二次分析,以探究孕妇对阴道分娩的偏好程度以及分娩分式与产后抑郁的联系。研究者们在24-36周询问孕妇其倾向于阴道分娩还是剖宫产,并通过标准的量表对其选择的偏好程度进行测定。然后分别在产后8-10周和6-8月,使用PHQ-9量表,对产妇进行产后抑郁评估。主要结局指标为

J Watch评价:对围存活期分娩的指导建议

一场主题为产科和新生儿实践的研讨会上提出了存活期分娩孕妇给予何样干预措施的观点和建议。有高风险围存活期分娩(periviable gestational ,指胎儿20 0/7周到25 6/7周早产)的女性需要提供多方面的管理和咨询,其分娩需要在能提供母胎医学和新生儿重症监护服务的三级医疗中心进行。20周和25周围存活期早产的婴儿存活率分别为0%和>50%。最近由母胎医学和围产期儿科专

J Immunol:自然分娩或更易增强新生儿免疫系统发育

许多研究都表明,相比自然出生的婴儿,剖腹产出生的婴儿机体往往具有不同的肠道菌群,但是发生这一现象的原因及其对机体免疫系统的影响尚不清楚;近日,来自哥本哈根大学的研究人员通过对新生小鼠进行研究,旨在揭示出生方式对小鼠机体免疫系统发育的影响,相关研究成果刊登于国际杂志The Journal of Immunology上。 研究者发现,通过剖腹产出生的小鼠幼崽机体中增强免疫系统的细胞数量往往较少,而通

AJOG:妊娠期肝内胆汁淤积症孕妇分娩时机的选择

妊娠期肝内胆汁淤积症ICP以胆汁酸升高、皮肤瘙痒等为主要表现, 通常见于孕晚期,其常常增加死胎风险。ICP发生率为0.2-2.0%,但是在中国西部地区,如四川、重庆,其发生率可达10%以上。对于诊断为ICP的孕妇临床上该如何去处理,是期待疗法还是立即分娩,两种治疗方法是否存在一个时间界限。因此Puljic A等人进行了一项回顾性研究,以探究该问题。该研究纳入了加利福利亚2005

Baidu
map
Baidu
map
Baidu
map