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目的评价可行走分娩镇痛在潜伏期应用的临床效果。研究宫口开张不同大小应用分娩镇痛后的产程进展,对子宫收缩力的影响及新生儿阿氏评分情况。方法对确诊已临产且无内科合并症初产妇共90例,随机分为三组。Ⅰ组:宫口开张1cm左右;Ⅱ组:宫口开张2～3cm;Ⅲ组为正常对照组未采用分娩镇痛。观察镇痛起效时间、子宫收缩力的变化、总产程、产后出血量、分娩结局及新生儿阿氏评分。结果Ⅰ组与Ⅲ组相比总产程无差异。Ⅰ组与Ⅱ组第一产程相比时间延长差异有统计学意义(P<0.05),Ⅱ组与Ⅲ组相比子宫收缩力无明显降低,第一产程中Ⅰ组与Ⅲ组相比子宫收缩力显著降低,P<0.05,催产素使用率为100%。三组间产后出血、新生儿阿氏评分各组间无显著差异。结论舒芬太尼合并低浓度的罗哌卡因引导下无痛分娩,从潜伏期应用,有明显的分娩镇痛作用,不增加产后出血量,对新生儿的阿氏评分无影响。
Objective To evaluate the clinical effect of labor analgesia in latent period. Study the application of different sizes of cervix maternity labor after labor progress, the impact of uterine contractility and neonatal Aspergillus score. Methods A total of 90 primiparae women who had been diagnosed and had no medical complications were randomly divided into three groups. Group Ⅰ: cervix opened about 1cm; Ⅱ group: cervix opened 2 ~ 3cm; Ⅲ group for the normal control group did not use labor analgesia. Observation of analgesic onset time, changes in uterine contractility, total labor, postpartum hemorrhage, delivery outcomes and neonatal Asperger score. Results There was no difference in total labor between Ⅰ and Ⅲ group. There was significant difference in the time prolongation of the first stage of labor between group Ⅰ and group Ⅱ (P <0.05), while there was no significant difference in the contractility of uterine between group Ⅱ and Ⅲ Force was significantly reduced, P <0.05, oxytocin use was 100%. Between the three groups of postpartum hemorrhage, neonatal Asperger scores were no significant differences between groups. Conclusion Sufentanil combined with low concentration of ropivacaine induced painless childbirth, from the incubation period, there are obvious analgesic effects of labor, do not increase the amount of postpartum hemorrhage, had no effect on the neonatal Ah’s score.