摘要
目的:探讨连续硬膜外阻滞分娩镇痛法的镇痛效果和对产程、母婴的影响以及经产妇有无必要采用镇痛分娩。方法:选择自愿要求分娩镇痛无禁忌证的足月经产妇80例作为观察组(A组),给予连续硬膜外分娩镇痛;同期要求分娩镇痛无禁忌证的足月初产妇80例作为对照1组(B组),同样给予连续硬膜外分娩镇痛;另设同期未行分娩镇痛的足月经产妇80例作为对照2组(C组),观察产妇生命体征、胎心,记录第一、二、三产程时间,疼痛的视觉模拟评分(VAS评分)、Bromage评分、分娩方式、缩宫素使用率、新生儿Apgar评分、产妇出血量等。结果:连续硬膜外阻滞分娩镇痛方法效果确切有效,A组与B组相比VAS评分差异无统计学意义,与C组相比差异有统计学意义,PA-C<0.01;A组产程快于C组,C组快于B组,经统计学分析,A组和C组第一产程活跃期和第二产程差异有统计学意义,PA-C<0.05,A、C两组与B组相比差异均有统计学意义,PA-B<0.05、PC-B<0.05;3组阴道手术产率和剖宫产率比较,差异无统计学意义;3组的Bromage评分比较,差异无统计学意义;A组和B组的缩宫素使用率高于C组,差异有统计学意义,PA-C<0.05、PB-C<0.05,A、B两组之间相比,B组较高,但差异无统计学意义;3组出血量差异无统计学意义;3组的新生儿Apgar评分相比,差异无统计学意义;结论:连续硬膜外阻滞分娩镇痛法安全有效,且运动阻滞轻,用药量少,适用于初产妇,同样也适用于经产妇,经产妇亦应根据情况和需要采用分娩镇痛。
Objective：To explore the analgesic effect of continuous epidural analgesia（CEA） and its effect on stages of labor,mothers and fetuses,and whether it is necessary for multiparous women to adopt continuous epidural analgesia for labor analgesia or not.Methods：80 full term multiparous women adopting labor analgesia voluntarily and without contraindication of labor analgesia were selected as observation group（group A）,then they were treated with continuous epidural analgesia;80 full term primiparous women adopting labor analgesia voluntarily and without contraindication of labor analgesia at the same time were selected as control 1 group（group B）,then they were treated with continuous epidural analgesia;80 full term multiparous women without labor analgesia at the same time were selected as control 2 group（group C）;the vital signs,fetal heart rates,the times of the first stage of labor,the second stage of labor and the third stage of labor,VAS scores,Bromage scores,delivery modes,the utilization rates of oxytocin,neonatal Apgar scores and the amounts of blood loss of lying-in women were observed and recorded.Results：Continuous epidural analgesia was effective for labor analgesia,there was no significant difference in VAS score between group A and group B,but there was significant difference in VAS score between group A and group C（PA-C0.01）;the labor course of group A was shorter than that of group C,and the labor course of group C was shorter than that of group B,there was significant difference in active phase of the first stage of labor and the second stage of labor between group A and group C（PA-C0.05）;there was significant difference between group A,group C and group B（PA-B0.05,PC-B0.05）;there was no significant difference in rates of vaginal delivery and cesarean section among the three groups;there was no significant difference in Bromage score among the three groups;the utilization rates of oxytocin in group A and group B were significantly higher than that in group C（PA-C0.05,PB-C0.05）;the utilization rate of oxytocin in group B was higher than that in group A,but there was no significant difference;there was no significant difference in the amount of blood loss among the three groups;there was no significant difference in Apgar score among the three groups.Conclusion：Continuous epidural analgesia is safe and effective for labor analgesia,the degree of motor block is mild,the dose of drug is low,which is suitable for primiparous women,multiparous women should adopt labor analgesia according to situation and demand.
出处
《中国妇幼保健》
CAS
北大核心
2011年第18期2834-2837,共4页
Maternal and Child Health Care of China
基金
河南省卫生厅科技攻关项目〔200903069〕
关键词
连续硬膜外阻滞
经产妇
分娩镇痛
罗哌卡因
芬太尼
Continuous epidural anesthesia
Multiparous women
Labor analgesia
Ropivacaine
Fentanyl
