第一产程潜伏期硬膜外间歇脉冲注药对产程和母婴的影响  

Effects of Ropivacaine combined with Sufentanil during the first stage of the incubation period on the epidural intermittent pulse injection on labor and mother-infant

作　　者：陆文敏[1] 林宗航[1] 苏适夷 唐琼琳 张雪影 Lu Wenmin;Lin Zonghang;Su Shiyi;Tang Qionglin;Zhang Xueying(Department of Anesthesiology,the Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan,Guangdong 511520,China)

机构地区：[1]广州医科大学附属第六医院<清远市人民医院>麻醉科,广东清远511520

出　　处：《医药前沿》2020年第15期36-37,共2页Journal of Frontiers of Medicine

基　　金：广东省清远市科技计划项目(2018B035)。

摘　　要：目的:探讨在第一产程潜伏期应用罗哌卡因复合舒芬太尼硬膜外间歇脉冲镇痛对于产程和母婴的影响。方法:选取广州医科大学附属第六医院收治的进行阴道分娩的单胎、足月、初产妇120例,采用随机数字表法随机分为A组(60例)和B组(60例)。A组产妇宫口小于3cm时行分娩镇痛,B组产妇宫口大于等于3cm时进行分娩镇痛,两组均使用无线镇痛系统硬膜外间歇脉冲注药分娩镇痛,比较两组产妇不同产程的VAS评分、时间以及新生儿Apgar评分。结果:两组(A组VS B组)产妇第一产程所需时间[(308.55±48.25)VS(303.22±51.39)min]、潜伏期所需时间[(35.92±9.01)VS(38.98±8.22)min]、活跃期所需时间[(4.29±0.46)VS(4.18±0.53)min]比较,差异无统计学意义(P>0.05)。不同时段新生儿Apgar评分,1min[(9.64±0.51)VS(9.56±0.64)分]、5min[(9.97±0.22)VS(9.95±0.42)分]比较,差异无统计学意义(P>0.05);与B组相比,A组第一产程(潜伏期)VAS评分显著降低[(0.6±0.2)VS(9.5±0.3)分],差异具有统计学意义(P<0.05),其余时段VAS评分比较,差异均无统计学意义(P>0.05)。结论:第一产程潜伏期宫口小于3cm时行无线镇痛系统硬膜外间歇脉冲注药分娩镇痛可减轻产妇潜伏期的疼痛,但对产妇的产程和新生儿均无明显影响,具有一定的临床意义。Objective To study the effect of Ropivacaine combined with Sufentanil epidural analgesia on labor process and maternal and infant in the first stage of labor.Methods 120 single full-term primipara with vaginal delivery in the Sixth Affiliated Hospital of Guangzhou Medical were randomly divided into two group:group A(n=60)and group B(n=60)according to the degree of uterine orifice enlargement.Analgesia was performed when the uterine orifice was less than 3 cm in group A and when the uterine orifice was greater than or equal to 3 cm in group B.Both groups used the wireless analgesic system to deliver epidural analgesia with intermittent pulse injection.The VAS scores,time and neonatal Apgar scores were compared between the two groups.Result The time required for the first stage of labor in two groups(Group A vs.Group B)[(308.55±48.25)VS(303.22±51.39)min],the time required for the incubation period[(35.92±9.01)VS(38.98±8.22)min],the time required for the active period[(4.29±0.46VS(4.18±0.53)min],the difference was not statistically significant between the two groups(P>0.05).Apgar score of newborns at different periods,1min[(9.64±0.51)VS(9.56±0.64)points],5min[(9.97±0.22)VS(9.95±0.42)points],the difference was not statistically significant between the two groups(P>0.05);Compared with group B,the first birth period(latency period)VAS score of group A Significantly reduced[(0.6±0.2)VS(9.5±0.3)points],the difference was statistically significant(P<0.05).The comparison of VAS scores in the other periods was not statistically significant(P>0.05).Conclusion Wireless analgesia system with epidural intermittent pulse injection during the first stage of labor while the incubation period is less than 3cm can reduce the pain during the incubation period,but it has no significant effect on the labor process and the newborn.

关 键 词：罗哌卡因 舒芬太尼 第一产程潜伏期 

分 类 号：R714[医药卫生—妇产科学]