摘要
目的研究活跃期行分娩镇痛,腰2~3间隙和腰3~4间隙行硬膜外分娩镇痛对分娩结局的影响。方法选择医院行椎管内药物分娩镇痛的产妇(产程在活跃期)100例,分为对照组(50例)与观察组(50例)。对照组腰2~3间隙穿刺向上置管行硬膜外镇痛,观察组腰3~4间隙穿刺向上置管行硬膜外镇痛。比较2组产妇生产过程中VAS达2分的时间,下肢阻滞程度,疼痛满意度,产妇的生命体征,产程、宫缩、胎心,新生儿的评分,不良反应及并发症。结果观察组硬膜外首次注药至出现无痛宫缩(VAS≤3分)时间为(9.16±2.25)min,对照组为(16.37±3.03)min,差异有统计学意义(P<0.05)。观察组硬膜外首次注药至产妇自评VAS≤2分的时间为(11.40±2.20)min,对照组为(21.34±2.12)min,差异有统计学意义(P<0.05)。观察组产妇疼痛满意度较对照组有明显优势,差异有统计学意义(P<0.05)。2组均无1例产妇出现下肢运动阻滞感觉,仅对照组出现下肢轻微麻木2例。观察组产妇的心率、血压、脉搏血氧饱和度波动幅度小于对照组,差异有统计学意义(P<0.05)。对照组5例需要给予快速补液和阿托品升压、提高心率;观察组产妇均生命体征平稳,未给予特殊处理。观察组第二产程、产后出血量均显著优于对照组,差异有统计学意义(P<0.05)。2组宫缩、胎心均正常,差异无统计学意义(P>0.05)。观察组自然分娩率、剖宫产率、催产素使用率分别为78%(39/50)、22%(11/50)和70%(35/50),对照组分别为76%(38/50)、24%(12/50)和72%(36/50),2组比较差异无统计学意义(P>0.05)。2组间新生儿评分比较,1 min和5 min Apgar评分均差异无统计学意义(P>0.05)。2组产妇应用分娩镇痛后均无尿潴留、恶心呕吐、呼吸抑制、皮肤瘙痒等情况发生。结论在产妇分娩活跃期给予腰3~4间隙穿刺向上置管行硬膜外镇痛相较于腰2~3间隙穿刺向上置管效果更佳,可有效提高镇痛效果,减少产妇痛苦,具有临�
Objective To investigate the effects of labor analgesia at active period,epidural labor analgesia in lumbar 2~3 space and lumbar 3~4 space on delivery outcome.Methods One hundred parturients(labor process in active stage)were divided into control group(n=50)and observation group(n=50).The epidural analgesia was performed by puncturing into lumbar 2~3 space in control group,and epidural analgesia was performed in observation group by puncturing into lumbar 3~4 space.The time of VAS reaching 2 points,the degree of lower limb block,pain satisfaction degree,vital signs,uterine contraction and fetal heart rate,neonatal score,side effects and complications were observed and compared between the two groups.Results The time from the first epidural injection to the occurrence of painless uterine contraction(VAS≤3 points)in the observation group was(9.16±2.25)min,while that in control group was(16.37±3.03)min,the difference was statistically significant(P<0.05).The time from the first epidural injection to the self-rated vas≤2 points in observation group was(11.40±2.20)min,while that in control group was(21.34±2.12)min,the difference was statistically significant(P<0.05).The pain satisfaction degree in observation group was superior to that in control group(P<0.05).No cases with lower limb motor block sensation were found in both groups,only 2 cases in control group had mild numbness.The fluctuation range of heart rate,blood pressure and pulse oxygen saturation in the observation group was significantly less than that in control group(P<0.05).Moreover second stage of labor and postpartum hemorrhage volume in observation group were sueprior to those in control group(P<0.05).There were no significant differences in the natural delivery rate,cesarean section rate and oxytocin use rate between the two groups(P>0.05).There were no significant differences in the Apgar scores at 1min and 5min between the two groups(P>0.05).In addition no cases with urinary retention,nausea and vomiting,respiratory depression,skin pruritus
作者
冯巧荣
张淑新
FENG Qiaorong;ZHANG Shuxin(Department of Anesthesiology,She County Hospital,Hebei,She County 056400,China)
出处
《河北医药》
CAS
2021年第19期2933-2936,共4页
Hebei Medical Journal
关键词
活跃期
椎管内药物分娩镇痛
分娩结局
疼痛评分
active stage
intraspinal drug analgesia for labor
delivery outcome
pain score
