可行走分娩镇痛应用于潜伏期对减轻产痛缩短产程的影响

目的评价可行走分娩镇痛在潜伏期应用的临床效果。研究宫口开张不同大小应用分娩镇痛后的产程进展，对子宫收缩力的影响及新生儿阿氏评分情况。方法对确诊已临产且无内科合并症初产妇共90例，随机分为三组。Ⅰ组：宫口开张1cm左右；Ⅱ组：宫口开张2—3cm；Ⅲ组为正常对照组未采用分娩镇痛。观察镇痛起效时间、子宫收缩力的变化、总产程、产后出血量、分娩结局及新生儿阿氏评分。结果Ⅰ组与Ⅲ组相比总产程无差异。Ⅰ组与Ⅱ组第一产程相比时间延长差异有统计学意义（P〈0．05），Ⅱ组与Ⅲ组相比子宫收缩力无明显降低，第一产程中Ⅰ组与Ⅲ组相比子宫收缩力显著降低，P〈0．05，催产素使用率为100％。三组间产后出血、新生儿阿氏评分各组间无显著差异。结论舒芬太尼合并低浓度的罗哌卡因引导下无痛分娩，从潜伏期应用，有明显的分娩镇痛作用，不增加产后出血量，对新生儿的阿氏评分无影响。

Clinical study on ambulatory labor analgesia used in latent phase of the first stage of labor

Objective To evaluate the clinical effect of ambulatory labor analgesia used in latent phase of the first stage of labor,which include labor progress,Apgar score after ambulatory labor analgesia begun to use when the cervix was different size dilatated.Methods 75 parturient nulliparae who had no complications were randomly divided into three groups:Group 1:Ambulatory labor analgesia was begun to use when the cervix was 1.0 cm dilated,Group 2:Ambulatory labor analgesia was begun to use when the cervix was 2-3 cm dilated,Group 3:Control group without use of ambulatory labor analgesia.Analgesic effects were observed,changes of uterine contraction were recorded by fetal monitor.Meanwhile,total stage of labor,outcome of delivery and Apgar score were recorded.Results Duration of tatal stage of labor had no significant differences between group 1 and group 3.The duration of the first labor stage was significantly longer in group 1 than that in group 2(P<0.05).Uterine contration power were not decreased in group 2 compared with group 3,during the first stage of labor,uterine contration power were significantly decreased,oxytocin was used in all.postpartum hemorrhage\apgar score in newborn are no significant inthree growp.Conclusion Using sufentanil combined with low rovipicanine for labor anglaesia from laten phase of frist labor,can relieve the ache.