【摘要】：目的探討脊麻-硬膜外聯(lián)合麻醉不同階段鎮(zhèn)痛對(duì)足月產(chǎn)婦分娩結(jié)局的影響差異。方法選取2013年7月至2014年5月于上海市浦東新區(qū)光明中醫(yī)醫(yī)院接受脊麻-硬膜外聯(lián)合麻醉分娩鎮(zhèn)痛方案的134例足月產(chǎn)婦為研究對(duì)象,按照隨機(jī)數(shù)字法分成潛伏期麻醉組(A組,n=67)和活躍期麻醉組(B組,n=67)。將同期入院分娩的60例未予以分娩鎮(zhèn)痛措施足月產(chǎn)婦納入對(duì)照組(C組,n=60)。比對(duì)三組產(chǎn)婦鎮(zhèn)痛穿刺前、泵注麻醉液后10 min、泵注麻醉液后30 min等時(shí)段內(nèi)鎮(zhèn)痛效果差異,記錄其產(chǎn)程進(jìn)展、分娩方式、新生兒阿氏評(píng)分(Apgar)、宮內(nèi)窘迫及新生兒窒息等并發(fā)癥發(fā)生情況。結(jié)果微量泵持續(xù)泵入麻醉液后,三組產(chǎn)婦VAS評(píng)分均較鎮(zhèn)痛穿刺前顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);其降幅A組B組C組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);三組產(chǎn)婦在第三產(chǎn)程對(duì)比上無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);宮頸口擴(kuò)張速度A組B組C組,且活躍期、第二產(chǎn)程均A組B組C組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);A、B、C組產(chǎn)婦陰道順產(chǎn)率分別為89.6%、74.6%、63.3%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);三組新生兒Apgar評(píng)分及難產(chǎn)率對(duì)比均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);其中A、B組新生兒宮內(nèi)窘迫及新生兒窒息發(fā)生率均顯著低于C組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論在潛伏期予以足月產(chǎn)婦脊麻-硬膜外聯(lián)合麻醉分娩鎮(zhèn)痛方案,可獲得理想的鎮(zhèn)痛效果,產(chǎn)婦產(chǎn)程無(wú)明顯延長(zhǎng)且母嬰結(jié)局理想,值得臨床推廣。
[Abstract]:Objective to investigate the effect of spinal-epidural anesthesia on labor outcome of full-term parturients. Methods from July 2013 to May 2014, 134 full-term parturients who received spinal-epidural combined anesthesia and analgesia in Guangming traditional Chinese Medicine Hospital in Pudong New area of Shanghai were selected as subjects and divided into latent period anesthesia group (group A) according to random number method. Group B (n = 67) and active anesthesia group (group B, n = 67). A total of 60 full-term parturients without labor analgesia were enrolled in the control group (group C, n = 60). The analgesic effects of three groups of parturients before analgesia puncture, 10 min, after infusion of anesthetic fluid and 30 min after infusion of anesthetic fluid were compared. The progress of labor process, mode of delivery and (Apgar), of newborn were recorded. Complications such as intrauterine distress and neonatal asphyxia. Results after continuous infusion of anesthetic solution, the VAS scores of the three groups were significantly lower than those before analgesia puncture (P0.05), and the extent of decrease was statistically significant in group A, group B and group C (P0.05). There was no significant difference in the third stage of labor among the three groups (P0.05); the cervical dilation rate of group A, group B, group C, and active stage, the second stage of labor, group A group B group C, the difference was statistically significant (P0.05); A, B, C group vaginal delivery rate were 89.6%, 74.6%, 63.3%, respectively, the difference was statistically significant (P0.05); there was no significant difference in neonatal Apgar score and dystocia rate among the three groups (P0.05); The incidence of intrauterine distress and neonatal asphyxia in group A and B was significantly lower than that in group C (P0.05). Conclusion the method of combined spinal-epidural anesthesia for labor analgesia in full-term parturients during the incubation period can obtain ideal analgesic effect. The parturient has no obvious prolongation of labor process and the mother-to-child outcome is ideal, so it is worth popularizing in clinical practice.
【作者單位】： 上海市浦東新區(qū)光明中醫(yī)醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R614

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬強(qiáng);;還是自然分娩好[J];農(nóng)村科技;1994年03期

2 王鳳蓮,張靈武,何秉潔;Doula分娩的臨床觀察[J];寧夏醫(yī)學(xué)院學(xué)報(bào);2003年03期

3 車(chē)建華,胡雙玖,譚文華,王吉賓;足月產(chǎn)婦和早產(chǎn)婦初乳和胎兒臍血中�；撬岷康臏y(cè)定及臨床意義[J];哈爾濱醫(yī)科大學(xué)學(xué)報(bào);1999年01期

4 趙姝;豆太;;妊娠合并急性闌尾炎18例臨床特點(diǎn)及診治體會(huì)[J];醫(yī)學(xué)信息(上旬刊);2011年08期

5 張萍芳,方愛(ài)華;足月產(chǎn)婦120例初乳免疫球蛋白水平變化分析[J];解放軍護(hù)理雜志;1999年01期

6 雷燕;鄭秋玲;黃玲;;RH陰性血型足月產(chǎn)婦的護(hù)理[J];當(dāng)代醫(yī)學(xué);2013年16期

7 趙峰;;足月產(chǎn)婦血漿D-二聚體水平分析[J];現(xiàn)代實(shí)用醫(yī)學(xué);2014年05期

8 許鳳娣，，葉偉民;正常足月產(chǎn)婦初乳及成熟乳中微量元素的含量[J];第二軍醫(yī)大學(xué)學(xué)報(bào);1994年02期

9 邵莉萍;陳友國(guó);楊紀(jì)實(shí);;268例早產(chǎn)臨床分析[J];江蘇醫(yī)藥;2012年04期

10 鄒海燕;;258例早產(chǎn)的臨床因素分析[J];現(xiàn)代預(yù)防醫(yī)學(xué);2012年13期

相關(guān)會(huì)議論文 前1條

1 朱琳;卡米拉;;孕產(chǎn)婦凝血因子變化及意義探討[A];中華醫(yī)學(xué)會(huì)血液學(xué)分會(huì)第十三屆全國(guó)血栓與止血學(xué)術(shù)會(huì)議暨“血栓栓塞性疾�。ㄑㄅc止血）基礎(chǔ)與臨床研究進(jìn)展”論文摘要匯編及學(xué)習(xí)班講義[C];2011年

本文編號(hào)：2438610