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可行走式无痛分娩镇痛在分娩中的应用

来源:用户上传      作者: 许海钿

  【摘要】 目的 探索可行走式无痛分娩镇痛在分娩中的应用效果及其影响。方法 180例孕产妇随机分为研究组和对照组, 各90例。对照组实施常规方式分娩, 研究组实施可行走式无痛分娩。将两组的分娩情况、各产程疼痛评分、产程以及新生儿情况进行对比。结果 研究组顺产比例为83.33%, 显著高于对照组的55.56%, 研究组剖宫产比例为13.33%, 显著低于对照组的38.89%, 差异均具有统计学意义(P<0.05);两组研究对象产钳助产比例差异无统计学意义(P>0.05)。研究组第一产程显著短于对照组(P<0.05), 研究组第二产程显著长于对照组(P<0.05), 两组第三产程差异无统计学意义(P>0.05)。研究组各产程视觉模拟评分法(VAS)评分均显著低于对照组(P<0.05)。两组研究对象胎儿窘迫比例以及各时间点的Apgar评分差异均无统计学意义(P>0.05)。结论 可行走式无痛分娩镇痛方式在分娩中可以产生良好的镇痛效果, 能有效降低生产疼痛感, 并发症发生率低, 安全性高, 具有极大的推广应用价值。
  【关键词】 镇痛;硬膜外;无痛分娩;分娩过程;产后出血
  DOI:10.14163/j.cnki.11-5547/r.2015.34.004
  Application of ambulatory painless labor analgesia in labor process XU Hai-dian. Shantou City Chenghai District Maternal and Child Health Care Hospital, Shantou 515800, China
  【Abstract】 Objective To explore application effect and influence of ambulatory painless labor analgesia in labor process. Methods A total of 180 pregnant women were randomly divided into research group and control group, with 90 cases in each group. The control group received conventional labor measure, and the research group received ambulatory painless labor. Comparisons were made on labor condition, pain score in every stage of labor, and neonatal status between the two groups. Results The research group had much higher eutocia rate as 83.33% than 55.56% of the control group, and its cesarean section rate was obviously lower as 13.33% than 38.89% of the control group. Their differences all had statistical significance (P<0.05). The difference of obstetric forceps delivery rate had no statistical significance between the two groups (P>0.05). The research group had remarkably shorter first labor stage (P<0.05) and longer second labor stage than the control group (P<0.05). The difference of the third labor stage between the two groups had no statistical significance (P>0.05). Visual analogue scale (VAS) scores in each stage were much lower in the research group than in the control group (P<0.05). There were no statistically significant differences of fetal distress rate and Apgar scores in each time point between the two groups (P>0.05). Conclusion Ambulatory painless labor analgesia can provide precise analgesic effect in labor process. This method can reduce labor pain, along with low incidence of adverse reactions and high safety. It contains great value of promotion and application.
  【Key words】 Analgesia; Epidural; Painless labor; Labor process; Postpartum hemorrhage
  正常情况下分娩将会给孕产妇带来巨大疼痛感。在目前的技术条件下, 还没有找到既能实现有效镇痛又能确保安全分娩的有效方法以及药物等。真正意义上的无痛分娩, 还有极大的研究和探索价值。分娩镇痛是指应用各种镇痛方法, 消除分娩时的疼痛, 或将分娩痛降至最低限度[1]。目前, 在降低剖宫产率的方法中, 分娩镇痛技术有着十分广阔的发展空间[2]。近年来, 随着麻醉医学以及围生医学的不断发展, 硬膜外自控镇痛(PCEA)方式已经逐步应用于分娩镇痛, 该方式不会对产妇的活动能力产生影响, 因此被叫做可行走式无痛分娩。本院积极探索研究可行走式无痛分娩镇痛在分娩中的应用效果及其影响, 取得了有价值的临床经验。具体情况如下。
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