椎管内分娩镇痛在子宫收缩中的应用优势分析  

Analysis on application advantages of intraspinal anesthesia for labor analgesia in uterine contraction

作　　者：王清枫 高锐 

机构地区：[1]德州市妇女儿童医院麻醉科,山东德州253015

出　　处：《中国妇幼保健》2017年第15期3655-3658,共4页Maternal and Child Health Care of China

基　　金：山东省卫生厅基金资助项目(2015HZ036)

摘　　要：目的分析椎管内分娩镇痛在子宫收缩中的应用优势。方法选取2014年5月-2016年5月收治的临产后自愿要求分娩镇痛的80例孕妇,随机分为腰硬联合阻滞镇痛组和硬膜外阻滞镇痛组,每组40例。比较两组孕妇的缩宫素应用率、子宫收缩持续时间、子宫收缩间隔时间、视觉模拟评分(VAS评分)、镇痛起效时间、用药量、按压次数。结果两组孕妇镇痛后缩宫素应用率均显著高于镇痛前,差异有统计学意义(P<0.05);两组孕妇镇痛前后缩宫素应用率比较差异均无统计学意义(P>0.05)。腰硬联合阻滞镇痛组中,镇痛后5、10、15、30 min子宫收缩持续时间均显著短于镇痛前(P<0.05);镇痛后15、30 min子宫收缩间隔时间均显著长于镇痛前(P<0.05);镇痛后5、10、15、30、60 min VAS评分均显著低于镇痛前(P<0.05)。硬膜外阻滞镇痛组中,镇痛后10、15、30 min子宫收缩持续时间均显著短于镇痛前(P<0.05);镇痛后5、10、15、30、60 min VAS评分均显著低于镇痛前(P<0.05)。镇痛后5、10、15 min,两组VAS评分比较,差异均有统计学意义(均P<0.05)。腰硬联合阻滞镇痛组孕妇的镇痛起效时间显著短于硬膜外阻滞镇痛组(P<0.05),但两组孕妇的用药量及按压次数比较差异均无统计学意义(P>0.05)。结论腰硬联合阻滞与硬膜外阻滞用于分娩镇痛效果良好,但会一过性影响子宫收缩,对其进行正确认识和处理能够为顺利实施分娩镇痛提供良好的前提条件。Objective To analyze the application advantages of intraspinal anesthesia for labor analgesia in uterine contraction. Methods A total of 80 pregnant women who received intraspinal anesthesia for labor analgesia voluntarily were selected from May 2014 to May2016. They were randomly divided into two groups： combined spinal with epidural anesthesia（ CSEA） group and epidural analgesia group,with 40 cases in each group. The application rates of oxytocin,duration time of uterine contraction,interval time of uterine contraction,visual analogue scores（ VAS scores）,onset time of analgesia,dosages and times of pressing were compared between the two groups.Results The application rates of oxytocin in the two groups after analgesia were both statistically significantly higher than those before analgesia（ P〈0. 05）,while there was no statistically significant difference in the application rate of oxytocin after analgesia between the two groups（ P〈0. 05）. In CSEA group,the duration time of uterine contraction at 5,10,15,and 30 minutes after analgesia was statistically significantly shorter than that before analgesia（ P〈0. 05）; the interval time of uterine contraction at 15 and 30 minutes after analgesia was statistically significantly longer than that before analgesia（ P〈0. 05）; VAS scores at 5,10,15,30,and 60 minutes after analgesia were statistically significantly lower than those before analgesia（ P〈0. 05）. In epidural analgesia group,the duration time of uterine contraction at10,15,and 30 minutes after analgesia was statistically significantly shorter than that before analgesia（ P〈0. 05）; VAS scores at 5,10,15,30,and 60 minutes after analgesia were statistically significantly lower than that before analgesia（ P〈0. 05）. There were statistically significant differences in VAS scores at 5,10,and 15 minutes after analgesia between the two groups（ P〈0. 05）. The onset time of analgesia in CSEA group was statistically significantly shorter than that in epidural analgesia gr

关 键 词：分娩镇痛 腰硬联合阻滞镇痛 硬膜外阻滞镇痛 子宫收缩 

分 类 号：R714.3[医药卫生—妇产科学]