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目的探讨全产程腰硬联合阻滞分娩镇痛的可行性和对潜伏期的影响。方法选择初产妇60例分为:A组(全产程组,宫口开张1cm左右),B组(活跃期组,宫口开张2~3cm),C组(对照组,未采用分娩镇痛),每组20例。A组、B组均采用蛛网膜下腔给药后硬膜外腔留管产妇自控镇痛(CSE+PCA),两组的蛛网膜下腔给药和硬膜外腔维持用药相同。观察A组、B组的镇痛时间、镇痛起效时间、运动阻滞、镇痛满意度等;观察三组的各时间点视觉模拟评分(VAS评分)、产程时间、出血量、新生儿Apgar评分、分娩方式、不良反应等。结果A组潜伏期时间0.05),C组各时间点VAS评分均比A、B组高(P<0.05)。A、B组副作用为瘙痒。结论全产程腰硬联合阻滞分娩镇痛效果确切,副作用少,可缩短潜伏期,对产妇和新生儿无不良影响。
Objective To investigate the feasibility of full-term combined spinal-epidural block labor analgesia and its influence on latency. Methods Sixty primipara patients were divided into three groups: group A (full-time group, cervix about 1cm), group B (active group, cervix 2 ~ 3cm), group C (control group, no labor analgesia) , 20 cases in each group. Patients in group A and group B received postoperative epidural analgesia (CSE + PCA) after subarachnoid administration, and subarachnoid administration and epidural maintenance in both groups were the same. The analgesic time, analgesic onset time, motor block and analgesia satisfaction were observed in group A and group B. The visual analogue scale (VAS score), labor duration, blood loss, neonatal Apgar score, mode of delivery, adverse reactions and more. Results The latency of group A was shorter than group B and group C (all P <0.05). The onset time of analgesia in group B was faster than that of group A (P <0.05) ), But there was no significant difference in the total amount of analgesics between the two groups (P> 0.05). The VAS score of C group at each time point was higher than that of A and B groups (P <0.05). A, B group side effects of itching. Conclusion Full-term combined spinal and epidural blockade of labor analgesia is exact, less side effects, can shorten the incubation period, no adverse effects on mothers and newborns.