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目的探究蛛网膜下腔阻滞联合硬膜外阻滞对产妇分娩方式及母婴结局的影响。方法根据产科镇痛方法将产科分娩镇痛的80例产妇分为硬膜外组(硬膜外阻滞)和联合组(蛛网膜下腔阻滞联合硬膜外阻滞),另选取120例同期未实行镇痛分娩产妇为对照组,对比分析3组分娩方式、产程时间变化、母儿合并症及麻醉后不良反应的发生情况。结果联合组和硬膜外组产钳助产率均高于对照组,剖宫产率低于对照组,差异有统计学意义(P<0.05);联合组阴道顺产率高于对照组和硬膜外组,产钳助产率低于硬膜外组,差异有统计学意义(P<0.05);联合组和硬膜外组活跃期延长、活跃期停滞、第二产程延长及胎儿窘迫发生率均高于对照组(P<0.05),而联合组和硬膜外组之间差异无统计学意义(P>0.05);联合组麻醉阻滞后头痛、皮肤瘙痒和低血压的发生率显著高于硬膜外组(P<0.05)。结论蛛网膜下腔阻滞联合硬膜外阻滞可降低剖宫产率和提高阴道顺产率,但是提高了产钳助产率,且与产程中活跃期延长、活跃期停滞、第二产程延长及胎儿窘迫的发生有关。
Objective To investigate the effects of subarachnoid block combined with epidural block on maternal delivery and maternal and infant outcomes. Methods According to the method of obstetric analgesia, 80 pregnant women with obstetric labor analgesia were divided into epidural group (epidural block) and combined group (subarachnoid block combined with epidural block). Another 120 cases In the same period, no analgesia was given to women in the control group. The three modes of delivery, labor time, maternal complications and adverse reactions after anesthesia were compared. Results The co-delivery rates of combined forceps and epidural forceps were higher than those of the control group, and the cesarean section rate was lower than that of the control group (P <0.05). The vaginal delivery rate in the combined group was higher than that in the control group and the dura In the external group, the rate of forceps delivery was lower than that of the epidural group (P <0.05). The active phase, the active phase, the prolonged second stage and the fetal distress rate in the combined group and the epidural group were both (P <0.05), while there was no significant difference between the combined group and the epidural group (P> 0.05). The incidence of headache, pruritus and hypotension in the combination group was significantly higher than that in the control group Epidural group (P <0.05). Conclusions Subarachnoid block combined with epidural block can reduce the rate of cesarean section and improve the vaginal delivery rate, but it increases the forceps delivery rate and prolongs the active period, active period, prolonged second stage of labor and Fetal distress occurs.