硬膜外阻滞全程分娩镇痛的可行性研究  

Feasibility of Whole-range Epidural Analgesia for Labor

作　　者：黎秀萍[1] 陈德坚[1] 曾垂应[2] 

机构地区：[1]广州医学院第一附属医院麻醉科,广东广州510120 [2]广州医学院,广东广州510182

出　　处：《现代生物医学进展》2010年第22期4279-4282,共4页Progress in Modern Biomedicine

基　　金：广东省第二批科技事业计划项目(33项目)(2005B36001020)

摘　　要：目的:评价全程硬膜外阻滞镇痛用于产妇分娩的效果及安全性。方法:随机分配40例无产科及硬膜外阻滞禁忌症的单胎初产妇,在正规宫缩开始后,分别按产妇需要行分娩镇痛,并根据镇痛实施的时机分成宫口≥3cm常规分娩镇痛组(I组)及宫口开1cm全程分娩镇痛组(Ⅱ组),对两组产妇行硬膜外阻滞,分别观察镇痛效果,总产程,分娩方式,新生儿血气分析,体重及新生儿阿氏评分。结果:两组共5例需行剖宫产,催产素使用情况两组相若。两组的第二、三产程、分娩方式、新生儿阿氏评分、体重、脐静脉血气分析、新生儿转归及产妇产后出血等比较均无显著性差异(P>0.05)。结论:分娩全程硬膜外镇痛可提供产妇产时和产后良好的镇痛效果,无延长第二、三产程时间,不增加产后出血,对新生儿阿氏评分无影响。Objectives：To evaluate the efficacy,safety and security of whole-range epidural analgesia for labor.Methods：Forty nulliparous primiparae without contraindication for epidural anesthesia were enrolled.Epidual analgesia was performed on demand after the emergence of regular uterine contraction,and the primiparae were divided into Group I or Ⅱ according to the timing of analgesia ini-tiation.Whole range analgesia was initiated instantly at the time of cervical dilatation=1 cm in group Ⅱ and conventional analgesia was administered when cervical dilatation ≥ 3 cm in Group I.Analgesia result,time length of labor,modes of delivery,neonatal blood gas analysis and weight,and neonatal Apgar score were recorded.Results：Cesarean section was needed in a total of 5 cases,and oxytocin dose was similar between the two groups.The two groups are not significantly different in time kength of labor stage II and III,modes of delivery,neonatal Apgar score,neonatal weight,umbilical venous blood gas analysis,neonatal outcome and postpartum hemorrhage（P〉0.05）.Conclusion：Whole range epidural analgesia provides parturients with favorable intra-partum and post-partum analgesia without delay of labor stage II and III,increase in postpartum hemorrhage and adverse effect on neonatal Apgar score.

关 键 词：硬膜外阻滞 全程 分娩镇痛 

分 类 号：R614[医药卫生—麻醉学]