腰硬联合麻醉用于无痛分娩的镇痛效果及其对分娩的影响

杨国庆1，刘德军1 ，程保育1 ，张顺2 ，赵盟涛3

（陕西中医药大学第二附属医院：1.麻醉科；2.心脏外科，陕西 咸阳，712000；3.陕西省咸阳市公安司法鉴定中心， 陕西 咸阳，712000）

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摘要：

目的 评价腰硬联合麻醉在无痛分娩中的镇痛效果及其对分娩的影响。方法 选取我院收治的66 例分娩产妇，其中将33 例行腰硬联合麻醉的无痛分娩产妇设置为试验组，并将其余33 例无分娩镇痛患者设置为参照组，比较两组产妇的镇痛 效果。结果 试验组产妇使用催产素率与会阴侧切率高于参照组（P<0.05）。试验组第一、二、三产程时间长于参照组，产后出 血量少于对照组，且Apgar 评分高于对照组（P<0.05）。试验组产妇I 级疼痛例数多于参照组，II、III 级疼痛例数少于参照组（P<0.05）。结论 腰硬联合麻醉用于无痛分娩中虽然会延长产程，但不会增加母婴不良结局发生率，效果良好，产后出血量 少，值得临床推广。

关键词：产时镇痛；腰硬联合麻醉；分娩

中图分类号：R614文献标志码：A文章编号：2096-1413(2017)36-0056-02

Evaluation of analgesic effect of combined spinal and epidural anesthesia in painless childbirth and its impact on childbirth
YANG Guo-qing 1, LIU De-jun 1, CHENG Bao-yu 1, ZHANG Shun 2, ZHAO Meng-tao 3
(1. Anesthesiology Department; 2. Cardiac Surgery Department, the Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000; 3. Public Security Judicial Identification Center of Xianyang City, Xianyang 712000, China)

ABSTRACT: Objective To evaluate the analgesic effect of combined spinal and epidural anesthesia in painless childbirth and its influence on childbirth. Methods A total of 66 maternal in our hospital were selected, 33 patients who treated with combined spinal and epidural anesthesia in painless childbirth were enrolled in the study group, and another 33 patients without childbirth analgesia were enrolled in the reference group. The analgesic effects of the two groups were compared Results The oxytocin using rate and the episiotomy rate in the study group were higher than those in the reference group (P<0.05). Time of the first, second, third stage of labor in the study group were longer than those of the reference group, the amount of postpartum hemorrhage was less than that of the reference group, and the Apgar score was higher than that of the reference group (P<0.05). The cases of I-grade pain in the study group was more than that in the reference group, while the cases of II and III-grade pain were less than those in the reference group (P<0.05). Conclusion Combined spinal and epidural anesthesia can prolong the labor in painless childbirth, but it does not increase the incidence of maternal and child adverse outcomes, with significant effect and less postpartum hemorrhage, which is worthy of clinical promotion.

KEYWORDS: analgesia during labor; combined spinal and epidural anesthesia; delivery

参考文献：
[1] 魏玉红.罗哌卡因复合芬太尼硬膜外麻醉镇痛用于无痛分娩的疗 效观察[J].中国实用医药,2013,8(16):177-178.
[2] 宋丽君.腰硬联合麻醉无痛分娩86 例临床护理研究[J].中国保健 营养(上旬刊),2013,23(3):1266-1267.
[3] 韩春芝.舒芬太尼联合罗哌卡因腰硬联合麻醉在无痛分娩中的应 用研究[J].中国伤残医学,2015,23(15):71-72.
[4] 董丽萍,蔡莉,刘虹,等.腰硬联合麻醉应用于无痛分娩的疗效及安 全性分析[J].中国现代医学杂志,2015,25(3):91-93.
[5] 刘骁,殷肃洁.腰硬联合麻醉无痛分娩84 例临床效果观察[J].大家 健康:学术版,2013,7(7):13-14.
[6] 黄阳,左美娟,顾海燕,等.腰硬联合麻醉在无痛分娩中的应用[J].江 苏医药,2014,40(12):1465-1466.
[7] 杜静.腰硬联合麻醉无痛分娩的临床观察与护理[J].当代临床医 刊,2016,29(4):2342.