摘要
目的:探讨麻醉的不同时机对产妇会阴部疼痛及撕裂程度等的影响。方法:选取2018年1月至2018年9月在衡水市第二人民医院阴道分娩的产妇300例,根据麻醉方式将产妇分为观察组(n=150)和对照组(n=150),其中观察组先露部下降至坐骨棘下约0. 5cm～1cm,用1%利多卡因行双侧会阴部神经阻滞麻醉,会阴切开前行局部浸润麻醉,对照组在胎头拨露后,会阴侧切前给予2%利多卡因局部浸润麻醉和切开侧会阴部神经阻滞麻醉,观察两组会阴疼痛、撕裂情况等。结果:观察组会阴部疼痛情况明显好于对照组,差异具有统计学意义(P <0. 05),其Ⅱ级及以下的比例达到56. 00%;观察组发生会阴撕裂的比例为6. 67%,明显低于对照组,差异具有统计学意义(P <0. 05);观察组会阴撕裂程度明显轻于对照组,差异具有统计学意义(P <0. 05);观察组第二产程和产后出血量分别为(35. 64±10. 12) min和(150. 50±30. 54) ml,明显低于对照组,差异具有统计学意义(P <0. 05);观察组下床活动时间和住院天数分别为(1. 41±0. 32) d和(3. 18±0. 97) d,明显少于对照组,差异具有统计学意义(P <0. 05)。结论:1%利多卡因行双侧会阴部神经阻滞麻醉比会阴切开前行局部浸润麻醉和切开侧会阴部神经阻滞麻醉有较好的效果,可减轻产妇会阴部疼痛和撕裂,缩短第二产程。
Objective:To compare the effects of different anesthetic timing on maternal perineal pain and tear.Methods:300 women adopted vaginal delivery from January 2018 to September 2018 in the Second People′s Hospital of Hengshui City were divided into the observation group(n=150)and the control group(n=150)according to the anesthesia method.1%lidocaine was used to block the bilateral perineal nerve and the local infiltration anesthesia was performed before perineotomy when the presenting part of the observation group descended about 0.5~1cm under the sciatic spine,and 2%lidocaine was used to perform the local infiltration anesthesia and perineal nerve block anesthesia before episiotomy when the head was visible on vulval gapping of the control group.The perineal pain and tear in the two groups were observed and compared.Results:The perineal pain in the observation group was smaller than that in the control group with statistically significant difference(P<0.05),and the proportion of theⅡgrade was 56.00%.The incidence of perineal tear in the observation group was 6.67%,which was significantly lower than that in the control group,with statistically significant difference(P<0.05).The degree of perineal tear in the observation group was significantly lower than that in the control group,with statistically significant difference(P<0.05).The hemorrhage of the second stage of labor and postpartum in the observation group were(35.64±10.12)min and(150.50±30.54)ml respectively,which were significantly lower than those in the control group,with statistically significant difference(P<0.05).The time of off-bed and hospital stay in the observation group were(1.41±0.32)d and(3.18±0.97)d respectively,which were significantly less than those in the control group,with statistically significant difference(P<0.05).Conclusions:The bilateral perineal nerve block anesthesia and local infiltration anesthesia with 1%lidocaine before perineotomy has a good effect,which can reduce the perineal pain and tear and shorten the second stage
作者
高运合
徐小溪
张志敏
康燕
刘俊国
GAO Yunhe;XU Xiaoxi;ZHANG Zhimin;KANG Yan;LIU Junguo(Department of Obstetrics and Gynecology,Second People′s Hospital of Hengshui City,Hengshui 053000,Hebei,China)
出处
《中国性科学》
2018年第11期79-81,共3页
Chinese Journal of Human Sexuality
基金
不同麻醉时机对会阴部疼痛及撕裂影响的临床研究(2017014013C-27)
