硬膜外联合蛛网膜下腔阻滞麻醉用于分娩镇痛213例的临床分析

目的探讨硬膜外联合蛛网膜下腔阻滞麻醉应用于分娩镇痛对产程、分娩方式、母婴合并症的影响。方法选择采川蛛网膜下腔联合硬膜外阻滞麻醉（CSEA）的甲胎、初产、足月、无其他合并症的产妇213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213例作为对照组。分别记录两组的产程时间、新生儿体重、剖宫产和阴道助产指征、胎儿冉内窘迫、新生儿窒息、产后出血、胎膜残留、尿潴留情况。结果镇痛后A组的第一产程活跃期和第二产程均缩短（P〈0．05），与B组比较有显著性差异。第一产程潜伏期、第三产程和总产程两组比较无显著性差异（P〉0．05）。结论分娩镇痛与非镇痛比较可使第一产程活跃期和第二产程缩短，不影响总产程，不增加剖宫产和阴道助产儿率，对母婴均较为安全。

Clinical analysis of 213 cases combined spinal epidural anesthesia for labor analgesia

Objective To discuss the impact of epidural spinal anesthesia used in labor analgesia on labor, delivery mode, maternal complications. Methods 213 matemals with single child, the beginning of production, full - term, no other complications were selected as pilot group, treated with spinal anesthesia combined with epidural anesthesia （CSEA） for labor analgesia . 213 cases of similar conditions and same period were randomly selected as control group, without any analgesic treatment. Labor duration, birth weight, cesarean section and vaginal delivery indications, fetal distress, neonatal asphyxia, postpartum hemorrhage, fetal membranes residue and urinary retention were recorded , respectively. Results A group of first analgesic products after the active stage and second stage of labor were shortened （P 〈 0. 05 ）, compared with B group were significantly different. Latency of the first stage, third stage of labor and total labor showed no significant difference （ P 〉 0. 05 ）. Conclusion Analgesia compared with non - analgesic active phase of labor can make the first and the second stage of labor reduced, does not affect the total process, without increasing the risk of caesarean section and vaginal delivery, the mother and child are safer.