不同时期腰—硬联合阻滞麻醉分娩镇痛对产程及母婴的影响(1)
[摘要] 目的 探讨不同时期腰-硬联合阻滞麻醉分娩镇痛对产程及母婴的影响。 方法 随机抽样选取本院2013年1月～2014年9月收治的75例初产妇，依据宫口长度将其分为3组，即宫口长度<3 cm组(A组)、宫口长度为3～4 cm组(B组)、宫口长度>4 cm组(C组)，各25例，均在不同时期进行腰-硬联合阻滞麻醉。观察3组产妇第一、二、三产程时间，分娩结局，对镇痛的满意度，应用视觉模拟评分法(VAS)对3组产妇不同时间点(镇痛前、潜伏期、镇痛后20 min、宫口全开、娩出胎儿时)的疼痛程度进行评定。 结果 A组产妇潜伏期的VAS评分显著低于B、C组(P<0.05)；A、B组产妇的第一产程时间均显著长于C组(P<0.05)；A组产妇的满意度为96.00%，显著高于B、C组(88.00%、88.00%)(P<0.05)。 结论 腰-硬联合阻滞麻醉对全产程均具有令人满意的分娩镇痛效果，不会使产程延长，能够显著提升母婴安全性，值得推广。
[关键词] 不同时期；腰-硬联合阻滞麻醉；分娩镇痛；产程；母婴；影响
[中图分类号] R614.4 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0079-03
The influence of spinal-epidural anesthesia analgesia during different period on maternal and child labor
ZHOU Jian-hua GAO Shan YU Qing
Department of Obstetrics and Gynecology，Maternal and Child Care Service Centre of Jingdezhen City in Jiangxi Province，Jingdezhen 333000，China
[Abstract] Objective To investigate the influence of spinal-epidural anesthesia analgesia during different period on maternal and child labor. Methods 75 cases of primipara in our hospital from January 2013 to September 2014 were randomly selected，and were divided into three groups according to cervix length，cervix length less than 3 cm were as group A，cervix length was 3-4 cm were as group B，cervix length more than 4 cm were as group C，25 cases in each group，all were taken with spinal-epidural anesthesia analgesia during different periods.The first，second and third stage of labor，birth outcomes，analgesia satisfaction of three groups was oberved，visual analogue scale (VAS) was taken to assess the pain during different period (before analgesia，the incubation period，analgesia 20 min，the cervix fully open，expulsion of the fetus). Results The VAS score during incubation period of group A was lower than that of group B and group C (P<0.05).The first stage of labor in group A and group B was longer than that in group C (P<0.05).The satisfaction of group A was 96.00%，higher than that of group B and group C (88.00%，88.00%) (P<0.05). Conclusion Spinal-epidural anesthesia has satisfactory analgesia effect for the whole production process，it does not extend the production process，and can improve maternal and child safety significantly，so is worthy of promotion.
[Key words] Different periods；Spinal-epidural anesthesia；Analgesia；Labor；Maternal and Child；Influence
随着市场经济的飞速发展和社会的不断进步，人民的生活水平日益提升，对人性化服务的要求越来越高，医疗模式随之不断转变，在现代产科麻醉的临床发展中，分娩镇痛已经成为必然趋势[1]。国外大力倡导全产程镇痛，但是我国实施分娩镇痛大多仅限于活跃期，认为早镇痛会促进第一产程极大延长和缩宫素应用率显著增高，严重的情况下还会促进剖宫产率显著提升，而过晚镇痛则缺乏一定的临床意义[2]。本研究探讨不同时期腰-硬联合阻滞麻醉分娩镇痛对产程及母婴的影响。 (周建华等)
[关键词] 不同时期；腰-硬联合阻滞麻醉；分娩镇痛；产程；母婴；影响
[中图分类号] R614.4 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0079-03
The influence of spinal-epidural anesthesia analgesia during different period on maternal and child labor
ZHOU Jian-hua GAO Shan YU Qing
Department of Obstetrics and Gynecology，Maternal and Child Care Service Centre of Jingdezhen City in Jiangxi Province，Jingdezhen 333000，China
[Abstract] Objective To investigate the influence of spinal-epidural anesthesia analgesia during different period on maternal and child labor. Methods 75 cases of primipara in our hospital from January 2013 to September 2014 were randomly selected，and were divided into three groups according to cervix length，cervix length less than 3 cm were as group A，cervix length was 3-4 cm were as group B，cervix length more than 4 cm were as group C，25 cases in each group，all were taken with spinal-epidural anesthesia analgesia during different periods.The first，second and third stage of labor，birth outcomes，analgesia satisfaction of three groups was oberved，visual analogue scale (VAS) was taken to assess the pain during different period (before analgesia，the incubation period，analgesia 20 min，the cervix fully open，expulsion of the fetus). Results The VAS score during incubation period of group A was lower than that of group B and group C (P<0.05).The first stage of labor in group A and group B was longer than that in group C (P<0.05).The satisfaction of group A was 96.00%，higher than that of group B and group C (88.00%，88.00%) (P<0.05). Conclusion Spinal-epidural anesthesia has satisfactory analgesia effect for the whole production process，it does not extend the production process，and can improve maternal and child safety significantly，so is worthy of promotion.
[Key words] Different periods；Spinal-epidural anesthesia；Analgesia；Labor；Maternal and Child；Influence
随着市场经济的飞速发展和社会的不断进步，人民的生活水平日益提升，对人性化服务的要求越来越高，医疗模式随之不断转变，在现代产科麻醉的临床发展中，分娩镇痛已经成为必然趋势[1]。国外大力倡导全产程镇痛，但是我国实施分娩镇痛大多仅限于活跃期，认为早镇痛会促进第一产程极大延长和缩宫素应用率显著增高，严重的情况下还会促进剖宫产率显著提升，而过晚镇痛则缺乏一定的临床意义[2]。本研究探讨不同时期腰-硬联合阻滞麻醉分娩镇痛对产程及母婴的影响。 (周建华等)