腰-硬联合阻滞及连续蛛网下腔阻滞对产妇分娩镇痛效果  

The effect of lumbar-epidural combined block and continuous subarachnoid block for labor analgesia

作　　者：王玥[1] 康凯[1] 白云波[1] 刘野[1] 徐铭军[1] WANG Yue;KANG Kai;BAI Yunbo;LIU Ye;XU Mingjun(Beijing Obstetrics and Gynecology Hospital,Capital Medical University 100026)

机构地区：[1]首都医科大学附属北京妇产医院,100026

出　　处：《中国计划生育学杂志》2021年第5期921-925,共5页Chinese Journal of Family Planning

基　　金：北京市卫生和计划生育委员会科技成果和适宜技术推广项目(2018-TG-21)。

摘　　要：目的:探究腰-硬联合阻滞及连续蛛网下腔阻滞对产妇分娩镇痛效果比较。方法:选取2019年6月-2020年6月在本院实行分娩镇痛的180例产妇作为研究对象,按照随机数表法分为观察组和常规组,常规组采取腰-硬联合阻滞,观察组采取连续蛛网下腔阻滞,观察两组产妇的临床生命体征、运动神经阻滞镇痛效果、焦虑与抑郁评分、母乳喂养率以及产程时间、新生儿Apgar评分、产后2h出血及产后并发症。结果:两组产妇麻醉前后生命体征无显著差异,经不同麻醉阻滞后,观察组运动神经阻滞率(1.1%)低于常规组(8.9%),镇痛有效率(88.9%)高于常规组(75.6%),产妇焦虑、抑郁情况更优,第一产程时间和第一产程时间更短(均P<0.05);两组产后2h出血和新生儿Apgar评分无差异(P>0.05);产后并发症发生率观察组(1.1%)低于常规组(8.9%)(P<0.05)。讨论:腰硬联合阻滞对产妇分娩镇痛效果更佳,可以有效缓解产妇疼痛,缩短产妇产程,改善产妇情绪,提升母乳喂养率。Objective: To explore the effect of lumbar-epidural combined block and continuous subarachnoid block for analgesia of women during delivery. Methods: 180 women who had accepted labor analgesia were selected as the research objects and were divided into research group and control group according to random number table from June 2019 to June 2020. The women in the control group were given combined spinal-epidural block, and the women in the research group were given continuous subarachnoid block. Clinical vital signs, motor nerve block analgesic effect, anxiety and depression scores, breastfeeding rate, duration of labor, Apgar score of newborns, postpartum 2 h hemorrhage volume, and postpartum complications rate of the women in the two groups were observed. Results: There was no significant difference in vital signs of the women before anesthesia between the two groups. After anesthesia, the motor nerve block rate(1.1%) in the research group was significant lower than that(8.9%) in the control group, and the analgesic effective rate(88.9%) in the research group was significant higher than that(75.6%) in the control group. The conditions of maternal anxiety and depression of the women in the research group were significant better, and the time of the first and the second stage of labor of the women in the research group were significant shorter(all P<0.05). There were no significant differences in postpartum 2 h hemorrhage volume of the women and neonatal Apgar score between the two groups(P>0.05). The incidence of postpartum complications(1.1%) of the women in the research group was significant lower than that(8.9%) of the women in the control group(P<0.05). Conclusion: The combined spinal-epidural block has better effect on labor analgesia of the women, which can effectively relieve the pain, shorten the stages of labor, improve the mood of the women, and increase the breastfeeding rate.

关 键 词：分娩镇痛 腰硬联合阻滞 连续蛛网下腔阻滞 

分 类 号：R714.3[医药卫生—妇产科学]