作者投稿
专家审稿
编辑办公
邮件订阅
RSS
Epidural Labor Analgesia: Comfort and Safety Run in Parallel, with Teaching and Quality Control Complementing Each Other
-
摘要: 分娩镇痛是以遵循产妇自愿和临床安全为原则，通过实施有效的分娩镇痛技术，以最大程度减轻产妇产痛的医疗服务。2018年，北京协和医院成为我国分娩镇痛首批试点单位，近年来在分娩镇痛高质量发展的各项工作中取得了满意成果。本文主要介绍北京协和医院分娩镇痛相关经验，具体包括：(1)合理调配人员安排，多学科联动制定标准化诊疗流程，为安全分娩提供舒适度保障；(2)完善危重孕产妇、新生儿救治方案，为安全分娩保驾护航；(3)传递先进的教学理念，将分娩镇痛培训与救治演练落到实处；(4)开展教育与科普讲座，帮助产妇树立科学分娩镇痛观。希望该经验分享可为我国各级诊疗机构提供参考和借鉴。Abstract: Epidural labor analgesia aims to provide effective medical services to alleviate labor pain in parturients, while adhering to the principles of voluntary participation and clinical safety. In 2018, Peking Union Medical College Hospital(PUMCH)became one of the first pilot units for labor analgesia in China, and has achieved satisfactory results in high-quality development of labor analgesia. This article mainly introduces the achievements and experience of labor analgesia at PUMCH, including: (1) prioritizing maternal and infant safety, arranging personnel rationally, and developing standardized treatment processes through multidisciplinary collaboration to ensure safe and comfortable childbirth; (2) leveraging the hospital's comprehensive capabilities in emergency treatment, and improving collaborative rescue plans for critically ill parturients and newborns; (3) implementing advanced teaching methods to effectively train and conduct simulated drills for labor analgesia and rescue of critically ill parturients; (4) conducting patient education and informative lectures to help parturients acquire a scientific understanding of labor analgesia. We hope that this experience can provide reference and inspiration for other hospitals.
-
作者贡献：张砡、赵梦芸、裴丽坚负责论文撰写及文献整理；龚亚红、阮侠、张羽冠、夏迪、鲁志龙、张占杰、周炯、付晨薇、高劲松负责数据整合、论文校对；黄宇光负责选题策划和论文审核。利益冲突：所有作者均声明不存在利益冲突
-
[1] Di G H, Yao S L, Wang J, et al. Factors influencing the improvement of neuraxial labor analgesia in China: a questionnaire survey[J]. Chin Med J (Engl), 2020, 133(5): 613-614. DOI: 10.1097/CM9.0000000000000529
[2] Wu J, Yao S L. Obstetric anesthesia in China: associated challenges and long-term goals[J]. Chin Med J (Engl), 2020, 133(5): 505-508. DOI: 10.1097/CM9.0000000000000664
[3] 中华人民共和国国家卫生健康委员会, 中华人民共和国国家发展和改革委员会, 中华人民共和国教育部, 等. 关于印发加强和完善麻醉医疗服务意见的通知[EB/OL]. (2018-08-08)[2024-01-02]. https://www.gov.cn/zhengce/zhengceku/2018-12/31/content_5435335.htm. [4] 中华人民共和国国家卫生健康委员会办公厅. 关于开展分娩镇痛试点工作的通知[EB/OL]. (2018-11-20)[2024-01-02]. http://www.nhc.gov.cn/yzygj/pqt/201811/e3d00e4a41f445fe89d100e6ee67c0a8.shtml. [5] 徐铭军, 黄宇光. 推广分娩镇痛工作, 提升分娩镇痛质量[J]. 中国医刊, 2022, 57(7): 697-700. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYI202207001.htm Xu M J, Huang Y G. Promote the analgesia of childbirth and improve the quality of analgesia in childbirth[J]. Chin J Med, 2022, 57(7): 697-700. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYI202207001.htm
[6] 中华人民共和国国家卫生健康委员会. 国家卫生健康委关于印发母婴安全行动提升计划(2021—2025年)的通知[EB/OL]. (2021-10-09)[2024-01-02]. https://www.gov.cn/zhengce/zhengceku/2021-10/15/content_5642740.htm. [7] Ma L L, Liu W, Huang Y G. Perioperative management for parturients with pulmonary hypertension: experience with 30 consecutive cases[J]. Front Med, 2012, 6(3): 307-310. DOI: 10.1007/s11684-012-0209-3
[8] Li X, Wu B Y, Zhang M Z, et al. A single-center retrospective cohort study on cesarean section under general anesthesia[J]. Chin Med Sci J, 2019, 34(4): 256-262. DOI: 10.24920/003541
[9] Starmer A J, Spector N D, Srivastava R, et al. Changes in medical errors after implementation of a handoff program[J]. N Engl J Med, 2014, 371(19): 1803-1812. DOI: 10.1056/NEJMsa1405556
[10] Starmer A J, Schnock K O, Lyons A, et al. Effects of the I-PASS nursing handoff bundle on communication quality and workflow[J]. BMJ Qual Saf, 2017, 26(12): 949-957. DOI: 10.1136/bmjqs-2016-006224
[11] 王维嘉, 裴丽坚, 高劲松, 等. 三级综合医院高风险孕产妇特点及救治经验[J]. 中国医学科学院学报, 2021, 43(6): 865-868. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYKX202106003.htm Wang W J, Pei L J, Gao J S, et al. Characteristics and management of high-risk maternal patients in general tertiary hospital[J]. Acta Acad Med Sin, 2021, 43(6): 865-868. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYKX202106003.htm
[12] Wang W, Pei L, Zhang Y, et al. Neuraxial anesthesia in ex utero intrapartum therapy for parturients with fetal congenital diaphragmatic hernia: a prospective observational study[J]. Int J Obstet Anesth, 2022, 52: 103599. DOI: 10.1016/j.ijoa.2022.103599
[13] 费昱达, 王境一, 王瑾, 等. 麻醉学教学中引入TeamSTEPPS团队教学课程的探索[J]. 中华医学教育杂志, 2021, 41(1): 62-65. Fei Y D, Wang J Y, Wang J, et al. Exploration of team strategies and tools to enhance performance and patient safety in anesthesia education[J]. Chin J Med Educ, 2021, 41(1): 62-65.
[14] Gong Y H, Pei L J, Ruan X, et al. Assessing empathy in anesthesia residents with the Chinese version of the consultation and relational empathy: a pilot standardized patient program[J]. Chin Med Sci J, 2021, 36(2): 79-84.
[15] 龚亚红, 王维嘉, 阮侠, 等. 不同年资和不同性别麻醉医师以患者为中心的医患沟通能力的比较[J]. 中华麻醉学杂志, 2021, 41(2): 201-206. DOI: 10.3760/cma.j.cn131073.20210107.00218 Gong Y H, Wang W J, Ruan X, et al. Comparison of patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders[J]. Chin J Anesthesiol, 2021, 41(2): 201-206. DOI: 10.3760/cma.j.cn131073.20210107.00218
[16] 阮侠, 李旭, 龚亚红, 等. 客观结构化临床考试(OSCE)在麻醉科住院医师评估中的应用[J]. 基础医学与临床, 2021, 41(9): 1383-1386. https://www.cnki.com.cn/Article/CJFDTOTAL-JCYL202109027.htm Ruan X, Li X, Gong Y H, et al. Application of objective structured clinical examination (OSCE) in the assessment of anesthetic residents[J]. Basic Clin Med, 2021, 41(9): 1383-1386. https://www.cnki.com.cn/Article/CJFDTOTAL-JCYL202109027.htm
[17] VanderLaan P A, Chen Y, Alex D, et al. Results from the 2019 American Society of Cytopathology survey on rapid on-site evaluation-Part 1: objective practice patterns[J]. J Am Soc Cytopathol, 2019, 8(6): 333-341. DOI: 10.1016/j.jasc.2019.07.007
[18] 龚亚红, 王维嘉, 范洪伟, 等. 标准化患者在评估麻醉临床型研究生术前访视能力中的应用[J]. 临床麻醉学杂志, 2019, 35(12): 1205-1208. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201912018.htm Gong Y H, Wang W J, Fan H W, et al. Application of standardized patients in the assessment of competency of graduate students in anes-thesiology in preoperative interview[J]. J Clin Anesthesiol, 2019, 35(12): 1205-1208. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201912018.htm
[19] Hao J, Yang L, Wang Y X, et al. Mobile prenatal education and its impact on reducing adverse pregnancy outcomes: retrospective real-world study[J]. JMIR Mhealth Uhealth, 2023, 11: e46910. DOI: 10.2196/46910
计量
- 文章访问数: 1422
- HTML全文浏览量: 49
- PDF下载量: 80
下载:
