腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床探讨(1)
[摘要] 目的 探讨腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床效果。方法 回顾分析2015年6月—2016年7月在该院分娩的80名孕妇临床资料，将其随机分为对照组和观察组，每组40名产妇，对照组采用硬膜外麻醉，观察组在对照组的基础上联合腰麻，观察对比两组产妇分娩疼痛度。结果 观察组产妇麻醉起效时间(3.51±1.22)min，明显短于对照组(10.11±4.56)min，麻醉药物用量(9.70±4.09)mg，明显少于对照组(19.34±6.79)mg，差异有统计学意义(P<0.05)；观察组产妇第一产程(227.3±104.1)min、第二产程时间(32.55±4.90)min，明显短于对照组(280.0±112.3)min、(49.45±7.09)min，差异有统计学意义(P<0.05)；观察组产妇镇痛评分(2.99±1.03)分，与对照组(2.91±0.89)分对比，差异无统计学意义(P>0.05)。结论 腰麻及硬膜外麻醉联合应用于产科分娩镇痛效果理想，且起效快，用药量少，促进产程的顺利进行，有效确保了母婴的安全。
[关键词] 腰麻；硬膜外麻醉；产科分娩
[中圖分类号] R71 [文献标识码] A [文章编号] 1674-0742(2017)05(b)-0104-03
[Abstract] Objective To explore the clinical effect of lumbar anesthesia and epidural anesthesia in the labor analgesia in the department of obstetrics. Methods 80 cases of delivery women giving birth in our hospital from June 2015 to July 2016 were selected and randomly divided into two groups with 40 cases in each， the control group adopted the epidural anesthesia， while the observation group adopted the lumbar anesthesia on the basis of the control group， and the delivery pains degree of the two groups was observed and compared. Results The anesthesia onset time in the observation group was obviously shorter than that in the control group[(3.51±1.22)min vs (10.11±4.56)min]， and the anesthesia drug dose was obviously fewer than that in the control group[(9.70±4.09)mg vs (19.34±6.79)mg]， and the difference was statistically significant(P<0.05)， and the first labor course and second labor course in the observation group were obviously shorter than those in the control group， [(227.3±104.1)min， (32.55±4.90)min vs (280.0±112.3)min， (49.45±7.09)min]， and the differences were statistically significant(P<0.05)， and the difference in the analgesia score between the observation group and the control group was not statistically significant， [(2.99±1.03)scores vs (2.91±0.89)scores]，(P>0.05). Conclusion The effect of combined application of lumbar anesthesia and epidural anesthesia in the labor analgesia in the department of obstetrics is ideal with rapid onset and few dosages， which can promote the successful operation of labor course and effectively ensure the maternal and infant safety.
[Key words] Lumbar anesthesia； Epidural anesthesia； Delivery in the department of obstetrics
产科是医院重要的科室之一，随着人们生活水平的提高产妇分娩镇痛，甚至是无痛越来越受关注。如何减轻产妇分娩疼痛，对母婴、分娩有至关重要的作用，也是当前产妇普遍关注的问题之一[1]。分娩是正常的生理过程，但是是一种极其疼痛并且较长产程的过程，孕妇通常会由于难以忍受疼痛，产生过度紧张，严重影响正常产程的顺利进行，引发产后出血等症状。同时产妇对产程疼痛通常存在恐惧、害怕心理，所以在分娩时容易放弃选择自然分娩，选择疼痛小的剖宫产，继而增加剖宫产率[2]。所以临床给予有效的镇痛可以减轻产妇的疼痛，促进产程的顺利进行。而分娩镇痛方案的正确选择具有重要的意义。该文作者结合2015年6月—2016年7月期间在该院分娩的80名孕妇临床资料，研究腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床效果，现报道如下。, 百拇医药(邹建方)
[关键词] 腰麻；硬膜外麻醉；产科分娩
[中圖分类号] R71 [文献标识码] A [文章编号] 1674-0742(2017)05(b)-0104-03
[Abstract] Objective To explore the clinical effect of lumbar anesthesia and epidural anesthesia in the labor analgesia in the department of obstetrics. Methods 80 cases of delivery women giving birth in our hospital from June 2015 to July 2016 were selected and randomly divided into two groups with 40 cases in each， the control group adopted the epidural anesthesia， while the observation group adopted the lumbar anesthesia on the basis of the control group， and the delivery pains degree of the two groups was observed and compared. Results The anesthesia onset time in the observation group was obviously shorter than that in the control group[(3.51±1.22)min vs (10.11±4.56)min]， and the anesthesia drug dose was obviously fewer than that in the control group[(9.70±4.09)mg vs (19.34±6.79)mg]， and the difference was statistically significant(P<0.05)， and the first labor course and second labor course in the observation group were obviously shorter than those in the control group， [(227.3±104.1)min， (32.55±4.90)min vs (280.0±112.3)min， (49.45±7.09)min]， and the differences were statistically significant(P<0.05)， and the difference in the analgesia score between the observation group and the control group was not statistically significant， [(2.99±1.03)scores vs (2.91±0.89)scores]，(P>0.05). Conclusion The effect of combined application of lumbar anesthesia and epidural anesthesia in the labor analgesia in the department of obstetrics is ideal with rapid onset and few dosages， which can promote the successful operation of labor course and effectively ensure the maternal and infant safety.
[Key words] Lumbar anesthesia； Epidural anesthesia； Delivery in the department of obstetrics
产科是医院重要的科室之一，随着人们生活水平的提高产妇分娩镇痛，甚至是无痛越来越受关注。如何减轻产妇分娩疼痛，对母婴、分娩有至关重要的作用，也是当前产妇普遍关注的问题之一[1]。分娩是正常的生理过程，但是是一种极其疼痛并且较长产程的过程，孕妇通常会由于难以忍受疼痛，产生过度紧张，严重影响正常产程的顺利进行，引发产后出血等症状。同时产妇对产程疼痛通常存在恐惧、害怕心理，所以在分娩时容易放弃选择自然分娩，选择疼痛小的剖宫产，继而增加剖宫产率[2]。所以临床给予有效的镇痛可以减轻产妇的疼痛，促进产程的顺利进行。而分娩镇痛方案的正确选择具有重要的意义。该文作者结合2015年6月—2016年7月期间在该院分娩的80名孕妇临床资料，研究腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床效果，现报道如下。, 百拇医药(邹建方)