摘要
目的探讨超声引导下阴部神经阻滞用于分娩镇痛的效果及会阴保护作用。方法选取2017年7-12月在我院经阴道分娩的初产妇80例,采用随机数字表法分为两组(超声组与盲探组),每组各40例。评价超声下阴部神经解剖结构清晰度,比较两组产妇第二、三产程的镇痛效果、会阴保护情况、器械助产率及阴部神经阻滞相关并发症等指标。结果超声组产妇的阴部神经解剖结构清晰度优良率达95%,两组产妇阴部神经阻滞后疼痛均得到明显缓解(P<0.05);超声组产妇的第二、三产程镇痛效果均优于对照组(P<0.05);超声组产妇会阴撕裂伤程度、会阴侧切率及局部血肿发生率均明显低于盲探组(P<0.05);两组产妇器械助产率差异无统计学意义(P>0.05)。结论第二产程应用超声引导行阴部神经阻滞能够发挥良好的分娩镇痛效果及会阴保护作用,降低局部血肿的发生率,有利于产妇的分娩后恢复。
Objective To investigate the efficacy of ultrasound-guided pudendal nerve block in labor analgesia and its effect for perineal protection.Methods Eighty primiparas undergoing vaginal delivery with pudendal nerve block between July and December,2017 in our center were randomized into 2 groups,in which pudendal nerve block was performed under ultrasound guidance(n=40)or by blind exploration(n=40).The articulation of the anatomical structures of the perineal nerve displayed by ultrasound was evaluated.The Visual Analog Scale(VAS)scores in the second and third stages of labor,perineal protection,instrument-assisted delivery rate,and complications related with perineal nerve block were compared between the 2 groups.Results The articulation of the anatomical structures of the perineum nerve was excellent in 95%of the patients in the ultrasound group.Compared with the scores before analgesia,the VAS scores during labor were significantly reduced in both groups(P<0.05).Compared with pudendal nerve block by blind exploration,ultrasound guidance produced better analgesic effect(P<0.05)with significantly reduced perineal laceration rate,episiotomy rate,and incidence of local hematoma(P<0.05).The instrument-assisted delivery rate did not differ significantly between the 2 groups(P>0.05).Conclusion Labor analgesia with ultrasound-guided pudendal nerve block during the second stage of labor provides more effective analgesia and perineal protection and reduces the incidence of local hematoma to promote the recovery of primiparas.
作者
颜娅
何才
梅杨
杨立伟
张萍
李有长
YAN Ya;HE Cai;MEI Yang;YANG Liwei;ZHANG Ping;LI Youchang(Department of Anesthesiology,Chongqing Health Center for Women and Children,Chongqing,401147,China;Department of Obstetrics,Chongqing Health Center for Women and Children,Chongqing,401147,China)
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2019年第10期987-990,共4页
Journal of Third Military Medical University
基金
重庆市卫生计生委医学科研项目(2017MSXM112)~~
关键词
超声引导
阴部神经阻滞
分娩镇痛
ultrasound guidance
pudendal nerve block
labor analgesia
