椎管内阻滞在分娩镇痛中的应用研究进展  

Research progress on the application of intrathecal block in labor analgesia

作　　者：马青[1] MA Qing(Department of Anesthesiology,Tianjin Shuige Hospital,Tianjin 300122,China)

机构地区：[1]天津市水阁医院麻醉科,天津300122

出　　处：《中国城乡企业卫生》2025年第2期15-18,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：分娩是指胎儿脱离母体成为独立个体的过程,分娩痛是产妇分娩时经历的恐惧-紧张-疼痛综合征,产妇可产生焦虑烦躁,造成产程延长、子宫收缩抑制等。在分娩过程中,持续性强烈应激反应可造成产妇会阴撕裂、会阴侧切等,影响产妇产后泌乳量及其自身与新生儿身心状态。良好的镇痛能够有效减少机体儿茶酚胺、β-内啡肽的释放,阻断伤害性刺激的传入与自主神经的传出,降低产妇不必要的能量消耗,进一步减少产妇的应激反应。随着分娩镇痛在临床上的普遍应用,椎管内阻滞已基本于各地医院广泛开展。椎管内阻滞在分娩镇痛中的应用方法主要为蛛网膜下腔麻醉联合硬膜外阻滞分娩镇痛、硬膜外阻滞分娩镇痛等。椎管内分娩镇痛具有很好的临床应用效果,但是在临床上要合理使用。本文对分娩镇痛过程中应用椎管内阻滞的基础进行了分析,对其应用方法进行了探讨,总结了椎管内阻滞在分娩镇痛中的应用药物,并阐述了椎管内阻滞在分娩镇痛中的应用注意事项,以期为椎管内阻滞在分娩镇痛中的应用提供参考。Delivery refers to the process in which the fetus separates from the mother's body and becomes an independent individual.Labor pain is a fear-tension-pain syndrome experienced by puerpera during delivery,which can cause anxiety and irritability,leading to prolonged labor and inhibition of uterine contractions.During the process of delivery,persistent strong stress reactions can cause perineal tearing,perineal lateral incision of puerpera,etc.,affecting postpartum milk production and the physical and mental state of the puerpera and newborn.Good analgesia can effectively reduce the release of catecholamines andβ-endorphins in the body,block the transmission of harmful stimuli and autonomic nervous system output,reduce unnecessary energy consumption of puerpera,and further reduce their stress response.With the widespread application of labor analgesia in clinical practice,intrathecal block has been widely carried out in hospitals across the country.The application methods of intrathecal block in labor analgesia mainly include subarachnoid anesthesia combined with epidural block for labor analgesia,epidural block for labor analgesia,etc.Intrathecal delivery analgesia has good clinical application effects,but it should be used reasonably in clinical practice.This article analyzes the basis of using intrathecal block in the process of labor analgesia,explores its application methods,summarizes the drugs used for intrathecal block in labor analgesia,and elaborates on the precautions for the application of intrathecal block in labor analgesia,in order to provide reference for the application of intrathecal block in labor analgesia.

关 键 词：椎管内阻滞 分娩 镇痛 研究进展 

分 类 号：R71[医药卫生—妇产科学]