硬膜外麻醉在分娩镇痛中的应用

目的：探讨硬膜外麻醉用于分娩镇痛的临床效果及对产程、母婴分娩结局的影响。方法：选取自然分娩的产妇216例,全部足月、单胎、头位,无妊娠并发症,无麻醉禁忌证,评估经阴道分娩无困难者,随机分为观察组和对照组各108例,观察组采用硬膜外麻醉分娩镇痛,对照组采用非药物性分娩镇痛。观察2组产妇分娩疼痛的程度、第二产程和第三产程时间、产后出血量及新生儿Apgar评分。结果：观察组产妇分娩期疼痛程度明显低于对照组（P〈0.01）,宫口扩张速度显著快于对照组（P〈0.01）,观察组均较对照组好,缩短硬膜外麻醉分娩镇痛活跃期和第三产程时间（P〈0.01）,2组产妇产后出血量和新生儿Apgar评分差异均无统计学意义（P〉0.05）。结论：硬膜外阻滞麻醉用于分娩镇痛是较为理想的方法,对母婴均有较高的安全性,可加速产程进展,值得推广。

Application of the epidural anesthesia in labor analgesia

Objective：To explore the clinical effects of the epidural anesthesia in labor analgesia,and its effects on stages of labor and pregnancy outcome of maternal and child. Methods：Two hundred and sixteen natural childbirth puerperas with vaginal delivery, full term,single fetus,vertex presentation and no pregnancy complications and anesthesia contraindications,were randomly divided into the observation group and control group. The labor analgesia in observation group and control group were treated with epidural block anesthesia and non-drug,respectively. The delivery pain,duration of second and third labor,postpartum hemorrhage and Apgar scoring of neonate in two groups were observed. Results：The degree of delivery pain in observation group was significantly lower than that in control group（P〈0. 01）. The expansion speed of cervix in observation group were significantly faster than that in control group（P〈0. 01）. The effect of epidural anesthesia on labor analgesia in observation group was better than that in control group,which could shorten the active stage and third stage of labor（P〈0. 01）. The differences of postpartum bleeding and neonatal Apgar score between two groups were not statistical significance（P〉0. 05）. Conclusions：The epidural anesthesia is an ideal method in labor analgesia, which can accelerate labor progress,and is safe and worthy of spreading.