腰-硬联合镇痛用于产科分娩的临床观察

目的探讨和研究罗哌卡因复合芬太尼腰-硬联合镇痛在分娩中应用的效果及其安全性。方法将112例于2011年2月～2012年2月期间人住本院，ASAI～Ⅱ级单胎头位足月即将分娩的初产妇，随机均匀分为观察组和对照组．每组56例。观察组患者分娩时实施镇痛，即给予罗哌卡因复合芬太尼腰-硬联合镇痛方法进行镇痛；对照组患者分娩时未采取任何镇痛措施。观察产妇的镇痛效果、产程进展、分娩方式、产后出血量及不良反应，并记录新生儿Apgar评分。结果观察组产妇镇痛效果明显，第一产程活跃期镇痛满意度显著高于对照组（P〈0．01），第二产程镇痛效果也明显好于对照组（P〈0．05）；观察组第一产程的活跃期明显缩短（P〈0．05）、第二产程、第三产程两组差异无统计学意义（P〉0．05）；顺产率明显高于对照组、剖宫产率明显低于对照组（P〈0．05），阴道助产率两组差异无统计学意义（P〉0．05）；两组产妇产后出血量、新生儿1min Apgar和5min Apgar评分均差异无统计学意义（P〉0．05）。结论罗哌卡因复合芬太尼腰-硬联合镇痛效果好，且能缩短产程，提高顺产率，并对妇婴影响小。

Clinical observation of spinal-epidural analgesia for obstetric delivery

Objective To explore and study of ropivacaine combined with fentanyl spinal-epidural analgesic effect and safety in the delivery of applications.Methods One hundred and twelve cases admitted to our hospital from February 2011 to February 2012,ASA Ⅰ to Ⅱ level single cephalic term about to give birth early maternal,randomly evenly divided into observation group and control group,each group of 56 cases.The observation group patients implementation of analgesia during childbirth,given ropivacaine combined with fentanyl spinal-epidural analgesia analgesia;The control group were not taken any analgesic during childbirth.The maternal analgesic effect,the progress of labor,mode of delivery,postpartum hemorrhage,and adverse reactions,and record the Apgar score were observed.Results The apparent analgesic was effect in observation group,the active period of the first stage of labor analgesia satisfaction was significantly higher than the control group(P < 0.01),the second stage of labor analgesic effect was significantly better than the control group(P < 0.05);Observation groupactive period of labor was significantly shorter(P < 0.05),the second stage of labor,the third stage of labor two groups no significant differences(P > 0.05);along the yield was significantly higher cesarean section rate was significantly lower than the control group(P < 0.05),vaginal delivery rate was no significant difference(P > 0.05);Two sets of maternal postpartum hemorrhage,the newborn 1 min Apgar and 5 min Apgar score,there was no significant difference(P > 0.05).Conclusion Ropivacaine compound fentanyl waist-epidural analgesic effect is good and it can shorten the production process,improve the yield of cis,and the effect is small for penetration.