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目的探讨持续硬膜外阻滞麻醉分娩对胎儿及新生儿的影响。方法选取分娩产妇440例,其中230例在分娩过程中应用硬膜外阻滞麻醉进行镇痛,作为观察组;另外210例产妇进行自然分娩,作为对照组。观察两组胎儿和新生儿的胎心率长变异幅度和胎心基线,胎儿入盆时和产妇宫口全开后胎方位为枕前位比例,新生儿Apagar评分和吮吸能力。结果观察组胎心率长变异幅度和胎心基线小于对照组,观察组入盆时和产妇宫口全开后胎方位为枕前位比例低于对照组,观察组新生儿出生后30min和60min时吮吸反射评分低于对照组,差异均有统计学意义(P<0.05)。结论持续硬膜外阻滞麻醉能有效缓解产妇疼痛,增加胎儿氧气供给量,平稳胎心;镇痛会影响胎方位旋转,延长胎儿受压时间,影响新生儿出生后的吮吸反射,但随着时间延长,吮吸反射逐渐升高至正常水平。
Objective To investigate the effect of continuous epidural anesthesia on fetus and newborn. Methods 440 cases of childbirth were selected, of which 230 cases of epidural anesthesia analgesia during childbirth, as the observation group; the other 210 cases of spontaneous labor, as a control group. Fetal and neonatal fetal heart rate variability and baseline fetal heart rate were observed. The fetal posterior fetus position at the time of fetus implantation and maternal cervix opening was the anterior occipital aspect ratio, neonatal Apagar score and sucking ability. Results The rate of fetal heart rate variability and baseline fetal heart rate in the observation group were lower than those in the control group. The proportion of the anterior occipital posterior portion of the fetus in the observation group was significantly lower than that of the control group When sucking reflex scores lower than the control group, the difference was statistically significant (P <0.05). Conclusion Continuous epidural anesthesia can effectively relieve maternal pain, increase fetal oxygen supply and smooth fetal heart rate. Analgesia may affect the rotation of fetus, prolong the compression time of fetus and influence the sucking reflexes of neonates after birth. However, As time goes on, sucking reflex rises gradually to normal level.