两种患者自控无痛分娩方式的临床研究  

Clinical research of two different ways of patient-controlled painless labor

作　　者：周珩[1] 邓娜[2] 梁佐迪[1] 刘炜炜[1] 蔡大升[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110002 [2]中国医科大学附属第四医院肿瘤内科,辽宁沈阳110032

出　　处：《临床军医杂志》2015年第7期744-746,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨产科患者自控无痛分娩方法的选择及其效果和安全性的比较。方法回顾性分析患者自控静脉镇痛(PCIA组)和患者自控硬膜外镇痛(PCEA组)的无痛分娩镇痛前和镇痛后5 min、10 min,30 min、1 h及宫口开全的各时间点的疼痛视觉模拟评分,对比两组镇痛相关并发症的发生率,剖宫产率,催产素使用率以及新生儿1 min和10 min Apgar评分。结果两组均可缓解宫缩痛,但PCEA组优于PCIA组(P<0.05)。PCEA组未发生呼吸抑制、镇静和低血压,PCIA组仅有1例发生呼吸抑制(P>0.05)。两组剖宫产率和新生儿1 min和10 min的Apgar评分无明显差异(P>0.05),但PCEA组催产素使用率高于PCIA组(P<0.05)。结论无痛分娩过程中PCEA效果优于PCIA,且不提高产妇镇痛相关并发症,但对于硬膜外穿刺困难和禁忌证的患者,PCIA可作为另一安全有效的方法。Objective To discuss the application of patient-controlled painless labor and the comparison of their effect and safety. Methods Our research is a retrospective analysis which is designed to test the visual analogue scale （ VAS ） before analgesia, 5 minutes, 10 minutes,30 minutes,60 minutes and cervix completely opened after analgesia. We compared the incidence of analge- sia related complications,the rate of cesarean section,the usage rate of oxytocin and the Apgar scores in 1 minute and t0 minutes. Results Both groups were able to alleviate the pain of uterine contraction, but PCEA group was superior to PCIA （ P 〈 0.05 ）. There was no respiratory depression, sedation or hypotension in PCEA group, and there was only 1 case of respiratory depression in PCIA group（ P 〉 0.05 ）. There was no significant difference in the rate of cesarean section and the Apgar scores in 1 minute and 10 mi- nutes between two groups, but the usage rate of oxytocin in PCEA group was higher than which in PCIA group（ P 〈 0.05 ）. Conclu- sion The effect of PCEA is superior to PCIA without increasing the incidence of analgesia related complications, but PCIA is an ef- fective method for the patients with difficulties and contraindications of epidural puncture.

关 键 词：无痛分娩 产科 患者自控镇痛 

分 类 号：R714[医药卫生—妇产科学]