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目的对比分析硬膜外自控镇痛-负荷量+自控量(PCEA-LP)与硬膜外自控镇痛-负荷量+持续输注剂量+自控量(PCEA-LCP)在产妇自控硬膜外分娩镇痛中的应用效果。方法选取2014年8月-2015年7月在云南省腾冲市中医医院自愿接受分娩镇痛的100例产妇为研究对象,根据入院顺序分为观察组和对照组,每组各50例。观察组采取PCEA-LP方式给药,对照组采取PCEA-LCP方式给药。结果两组产妇术后1hVAS评分、宫缩时SpO_2、瘙痒发生率、面罩呼气末CO_2分压、负荷量后起效时间比较,差异无统计学意义(P>0.05),但观察组产妇在术后5h、10h、24h的VAS评分和总药量显著少于对照组产妇,差异有统计学意义(P<0.05)。两组产妇活跃期时间、产程时间、新生儿体重、Apgar评分比较,差异无统计学意义(P>0.05)。结论2μg/ml芬太尼和0.2%罗哌卡因应用在产妇自控硬膜外分娩镇痛中,属于安全有效的镇痛方案。当分娩镇痛水平相同时,PCEA-LP镇痛模式用药较少,副作用发生率较低。
OBJECTIVE: To compare the efficacy of PCEA-LP with PCEA-PCEA-LCP in the control of epidural delivery Analgesic effect of the application. Methods A total of 100 maternal women who received labor analgesia voluntarily from August 2014 to July 2015 in Tengchong Traditional Chinese Medicine Hospital of Yunnan Province were enrolled in this study. The patients were divided into observation group and control group according to admission sequence, with 50 cases in each group. The observation group was administered with PCEA-LP and the control group with PCEA-LCP. Results There was no significant difference in VAS scores at 1 h postoperatively, SpO_2, pruritus at the time of contractions, partial pressure of CO_2 at end expiration of mask, and time after onset of loading, but the difference was not significant (P> 0.05) The VAS score and the total dose at 5h, 10h and 24h after operation were significantly lower than those in the control group (P <0.05). There was no significant difference in active period, labor time, newborn weight and Apgar score between the two groups (P> 0.05). Conclusions 2μg / ml fentanyl and 0.2% ropivacaine are safe and effective analgesia in maternal self-controlled epidural analgesia. When labor analgesia levels were the same, PCEA-LP analgesia modeled less medication and had fewer side effects.