无创接生联合阴部神经阻滞麻醉在自然分娩中的应用价值

目的:探析无创接生术+阴部神经阻滞麻醉在经阴道自然分娩初产妇中的临床意义.方法:分析2015年4月~2016年8月在我院产科进行阴道自然分娩的84例初产妇的临床资料.随机将入选者均分成A组(无创接生+阴部神经阻滞麻醉)和B组(无创接生)两组,每组42例.比较两组产妇的基线资料、会阴撕裂率及其程度、不同时段的视觉模拟评分(VAS)、第二产程时间及新生儿窒息率以及产后恢复情况.结果:两组产妇的基线资料无显著性差异.B组产妇的会阴撕裂率(35.7%)明显较A组(9.5%)高.B组产妇在胎儿娩出时(t1)、阴道缝合时(t2)及产妇产后2h时(t3)的VAS评分均显著高于A组.B组产妇第二产程时间明显长于A组产妇;但两组新生儿窒息率无显著差异.A组产妇产后总住院时间、首次下床活动时间及并发症发生率均显著低于B组.结论:创接生术+阴部神经阻滞麻醉在经阴道自然分娩初产妇中具有重要的临床指导意义,不仅安全可靠,而且可以显著提升阴道分娩结局,值得推广.

The application value of noninvasive delivery+pudendal nerve block anesthesia in vaginal delivery

Objective Our retrospective study was aimed toanalyze the clinical value of noninvasive delivery + pudendal nerve block anesthesia in primiparas with vaginal delivery. Methods Clinical data of 84 primiparas with vaginal deliveryat our hospitalfrom April, 2015 to August, 2016 was retrospectivelyanalyzed. Patients included were divided into two groups at ran-dom, group A (noninvasive delivery+pudendal nerve block anesthesia) and group B (noninvasive delivery), 42 cases in each group. The general information, perineal laceration degree and incidence rate, the VAS scores at different times, time of the second stage of labor, neonatal asphyxia and maternal postpartum recovery in two groups were compared. Results The general information in two groups had no statistical difference. The perineal laceration incidence rate in group B (35.7%) was obviously higher than that in group A (9.5%). The VAS scores at in fetal childbirth (t1), vaginal suture (t2), postpartum 2h (t3) in group B were all obviously higher than those in group A. The time of the second stage of labor in group B was significantly longer than that in group A, but the rates of neonatal asphyxia in two groups had no statistical difference. The total hospital stay, firstly get-ting out of bed activity time and incidence of postpartum complications in group A were all obviously lower than those in group B. Conclusion The noninvasive delivery+pudendal nerve block anesthesia has clinical significance in primiparas with vaginal delivery. It's not only safe and reliable, but also can improve vaginal delivery quality. It's worth promoting.