可行走分娩镇痛应用于潜伏期的临床研究  

Clinical study on ambulatory labor analgesia used in latent phase of the first stage of labor

作　　者：张玉洁[1] 吴燕云[2] 刘继云[2] 邓玲红[1] 王冬昱[1] 陆佩华[1] 顾正田[1] 康佳丽[1] 

机构地区：[1]广州市第一人民医院妇产科,510180 [2]广州市第一人民医院麻醉科,510180

出　　处：《中国医师进修杂志》2006年第11期24-26,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价可行走分娩镇痛在潜伏期应用的临床效果。研究宫口开张不同大小应用分娩镇痛后的产程进展，对子宫收缩力的影响及新生儿Apgar评分情况。方法确认已临产无内科合并症的初产妇共75例，随机分为三组。Ⅰ组：宫口开张1cm左右；组：宫口开张2～3cm；Ⅲ组为正常对照组未采用分娩镇痛。观察镇痛起效时间、子宫收缩力的变化、总产程、产后出血量、分娩结局及新生儿Apgar评分。结果Ⅰ组与Ⅲ组比较总产程差异无统计学意义。Ⅰ组与Ⅱ组第一产程比较时间延长，差异有统计学意义（P〈0．05），Ⅱ组与Ⅲ组比较子宫收缩力无明显降低，第一产程中Ⅰ组与Ⅲ组比较子宫收缩力显著降低，P（0．05，Ⅰ组催产素使用率为100％。三组间产后出血、新生儿Apgar评分各组间差异无统计学意义。结论舒芬太尼合并低浓度的罗哌卡因引导下无痛分娩，从潜伏期应用，有明显的分娩镇痛作用，不增加产后出血量，对新生儿的Apgar评分无影响。ObJective To evaluate the clinical effect of ambulatory labor analgesia used in latent phase of the first stage of labor, which include labor progress, Apgar score after ambulatory labor analge- sia begun to use when the cervix was different size dilatated. Methods Seventy - five parturient primiparas who had no complication were randomly divided into three groups： group Ⅰ ： ambulatory labor analgesia was begun to use when the cervix was 1.0 cm dilated, group Ⅱ ： ambulatory labor analgesia was begun to use when the cervix was 2 - 3 cm dilated, group Ⅲ： control group without use of ambulatory labor analgesia. Analgesic effects were observed, changes of uterine contraction were recorded by fetal monitor. Meanwhile, total stage of labor ,outcome of delivery and Apgar score were recorded. Results Duration of total stage of labor had no significant difference between group Ⅰ and group Ⅲ. The duration of the first labor stage was significantly longer in group Ⅰ than that in group Ⅱ （ P 〈 0.05）. Uterine contraction power were not decreased in group Ⅱ compared with group Ⅲ, during the first stage of labor, uterine contraction power were significantly decreased, oxytocin was used in all. Postpartum hemorrhage, Apgar score in newborn were no significant in three groups. Conclusion Using sufentanil combined with low rovipicanine for labor analgesia from latent phase of first labor can relieve the pain of labor, at the same time postpartum hemorrhage has no increased and Apgar score in newborn are not affected.

关 键 词：无痛分娩 镇痛 宫缩力 产后出血 新生儿Apgar评分 

分 类 号：R714.3[医药卫生—妇产科学]