硬膜外阻滞在中期妊娠引产镇痛时机选择的临床观察

目的：比较硬膜外阻滞在中期妊娠引产不同时点开始镇痛的临床效果。方法选取我院60例因计划外妊娠或有胎儿畸形等妊娠合并症要求终止妊娠者，随机分为两组实施硬膜外阻滞，A组为病房常规处理后产妇有疼痛感即开始实施麻醉，B组为病房常规处理后有规律宫缩开始实施麻醉，每组30例；记录镇痛开始前及镇痛后生命体征、各时点孕妇的VAS评分和运动神经阻滞分级、引产时间、出血量及不良反应情况。结果与B组比较，A组在镇痛后各时点VAS评分降低、引产时间延长，差异均有统计学意义（P＜0.05）；两组间孕妇引产期间生命体征平稳，出血量及不良反应差异无统计学意义（P＞0.05）。结论中期妊娠引产无须考虑胎儿因素，早期实施麻醉镇痛干预更为合理，在不增加出血量和不良反应的基础上引产时间略有延长。

Clinical observation of epidural block in metaphase induced labor analgesia

Objective To compare the epidural block in metaphase induced labor at different points of analgesia and its related data. Methods Sixty cases who had termination of pregnancy in our hospital due to unplanned pregnancy or a birth defect were selected and were randomly divided into two groups for epidural block age after conventional treat-ment：group A, in which the anaesthesia was initiated when the maternal had pain, while women in group B had anesthesia （incubation period） after regular contractions began and were treated in the ward for routine treatment. Thirty cases were included in each group. The vital signs, VAS score at each point, motor nerve block classification, induced labor time, blood loss and adverse reactions were recorded before and after analgesia. Results Compared with group B, the VAS score in group A at each point was lower, the labor time was slightly longer and the difference was statistically significant （P〈 0.05）. Vital signs during induced labor bleeding between the two groups was not statistically different （P〉 0.05）. Conclusion Since it is unnecessary to consider the status of fetus during metaphase induced labor, it is reasonable to start analgesic anaesthesia early. This approach does not increase the frequency of blood loss but the induced labor time is slightly prolonged.