瑞芬太尼自控镇痛在自然分娩产妇中的应用

目的：探讨瑞芬太尼自控镇痛在自然分娩产妇中的应用。方法自然分娩患者90例随机分为瑞芬太尼组和对照组，每组各45例，对照组患者按照传统自然分娩流程进行，不使用任何镇痛措施，瑞芬太尼组在产妇宫口开至1 cm并有规律宫缩时行自控镇痛，镇痛药为瑞芬太尼20μg／mL，输注速度为0．02μg／（kg· min），产妇在规律宫缩后根据疼痛程度自己追加剂量，分别于镇痛前、镇痛后1、2 h和3 h测定两组产妇SBP、DBP和VAS评分，记录三个产程的时间、分娩过程中不良反应发生率和产后2 h出血量。结果镇痛后各时点SBP、DBP、 VAS值瑞芬太尼组均明显低于对照组（ P＜0.05，P＜0.01），瑞芬太尼组第一产程时间较对照组明显缩短（ P＜0．05），第二产程时间瑞芬太尼组较对照组明显延长（ P＜0．05），产后2 h出血量瑞芬太尼组明显少于对照组（ P＜0．05）。结论瑞芬太尼自控镇痛用于自然分娩产妇可有效缓解产妇疼痛，产后出血量减少，可在临床中广泛推广。

The Application of Rui Fentanyl Self-control Analgesia in Natural Childbirth Puerperae

Objective to study the application of Rui fentanyl self-control analgesia in natural childbirth puerperae.Methods 90 natural childbirth puerperae were randomly divided intoRuiFent-anyl group and control group, 45 cases in each group.The control group was taken by the tradi-tional natural birth process without any analgesia measures.When the puerperae palace opened to 1 cm and had regular contractions in the Rui fentanyl group, the self-control analgesia was adopted.The analgesicswere Rui Fentanyl （ including 20μg） and the infusion speed was 0.02μg （kg· min）.Thepuerperae can add analgesia according to the degree of pain after regular contractions.The SBP,DBP,and VAS scores were written respectively before the analgesia,1,2 h and 3 h after analgesia.The birth process times, the incidence of adverse reactionsand the process of childbirth and the bleeding postpartum 2 h were recorded.Results The SBP,DBP and VAS scores in the RuiFentanyl group in each stageafter analgesia were significantly lower than those in the control group （ P〈0.05,P〈0.01） .The first labor time in the Rui Fentanyl group was significantly shortened （P〈0.05） and the second labor time was obviously longer than that in the control group （ P〈0.05） .The bleeding in theRuiFentanylpostpartum 2 h was significantly less than that in the control group （ P〈0.05） .Conclusions The application of Rui Fentanyl self-control analgesia in natural childbirth puerperae can relieve the pain and reduce the amount of postpar-tum hemorrhage.It can be widely popularized in clinic.