论文部分内容阅读
目的探讨罗哌卡因与芬太尼联合应用于分娩镇痛对产程、分娩方式、母儿合并症的影响。方法采用蛛网膜下腔-硬膜外联阻麻醉(CSEA)用于单胎、初产、足月、无其他合并症产妇256例作为试验组,随机选择同期条件相似,未进行任何镇痛处理的产妇260例作为对照组。分别纪录两组的产程时间、新生儿体重、剖宫产和阴道助产指征、胎儿宫内窘迫、新生儿窒息、产后出血、胎膜残留、尿潴留情况。结果镇痛组活跃期较对照组明显短,而第二产程对照组长,总产程、第三产程及新生儿体重两组比较无显著性差异。镇痛组剖宫产率无显著性差异,缩宫素使用率明显高于对照组。镇痛组的阴道助产指征产程停滞最为常见,而在剖宫产指征中则枕位异常比例最高。镇痛组的尿潴留发生率高,而胎儿宫内窘迫、新生儿窒息、产后出血、胎膜残留两组比较均无差异。结论分娩镇痛可使第一产程缩短,第二产程延长,不影响总产程,不增加剖宫产和阴道助产机率,对母儿均较为安全。
Objective To investigate the effects of ropivacaine combined with fentanyl on labor process, delivery mode and maternal complications in labor. Methods The subarachnoid-epidural anesthesia (CSEA) was used in 256 single-fetus, primiparous, full-term, and no other comorbid women as the experimental group. The patients were randomly selected to have similar conditions at the same period without any analgesic treatment 260 maternal as a control group. The duration of labor, neonatal weight, indications of cesarean section and vaginal delivery, fetal distress, neonatal asphyxia, postpartum hemorrhage, residual fetal membranes and urinary retention were recorded. Results The active phase of the analgesic group was significantly shorter than that of the control group, while there was no significant difference between the two groups in the length of the second stage of labor, head of total labor, third stage of labor and neonatal weight. Analgesia group cesarean section rate was no significant difference, oxytocin use rate was significantly higher than the control group. Analgesia group of vaginal delivery midwifery indications the most common, while in cesarean indications, the highest proportion of occipital abnormalities. The incidence of urinary retention in the analgesic group was high, but there was no difference between the two groups in terms of fetal distress, neonatal asphyxia, postpartum hemorrhage and residual fetal membranes. Conclusion Labor analgesia can shorten the first stage of labor, prolongation of the second stage of labor, does not affect the total labor process, does not increase the chance of cesarean section and vaginal delivery, more safe for both mother and child.