摘要
目的探讨自控硬膜外麻醉在分娩镇痛中的效果及对产程、分娩结局和新生儿的影响。方法选取2012年11月~2015年2月在本院定期产检且自愿实施PCEA分娩的368例产妇作为观察组,选取同期未实施镇痛分娩且无阴道分娩禁忌证的380例初产妇作为对照组。观察PCEA镇痛方法对产程、分娩方式、产后24 h阴道出血量的影响,并通过对新生儿Apgar评分和新生儿24 h行为神经评分分析,了解PCEA镇痛方法对新生儿的影响。结果观察组的镇痛效果显著优于对照组,差异有统计学意义（P〈0.05）。观察组的第一产程活跃期显著短于对照组,差异有统计学意义（P〈0.05）。观察组的第二产程时间显著长于对照组,差异有统计学意义（P〈0.05）。两组的产后出血量比较,差异无统计学意义（P〉0.05）。观察组的剖宫产率显著低于对照组,自然分娩率显著高于对照组,差异有统计学意义（P〈0.05）。两组的新生儿窒息率及24 h行为神经评分异常发生率比较,差异无统计学意义（P〉0.05）。结论自控硬膜外麻醉分娩镇痛效果好,副作用少,可加速第一产程进展（特别是活跃期）,能够降低剖宫产率,提高阴道分娩率,且不增加母婴并发症。
Objective To explore the application effect of patient controlled epidural analgesia in labor analgesia and its influence on duration of labor,delivery outcome and newborn. Methods 368 pregnant women with PCEA delivery and periodic examination in our hospital from February 2015 to November 2012 were selected as the observation group, 380 cases of non delivery of analgesic labor and no vaginal delivery contraindication in the same period were selected as the control group.The effect of PCEA analgesia on the duration of labor,mode of delivery,postpartum the amount of vaginal bleeding at 24 hours were observed.The effect of PCEA on the score of neonatal Apgar and neonatal behavioral neurological assessment analysis for 24 hours was analyzed to understand the effect of PCEA on newborn. Results The analgesia efficiency of the observation group was better than that of the control group,with significant difference （P〈 O.05）.The active phase of the first labor average time in the observation group was shorter than that in the control group,with significant difference（P〈0.05）.The second labor average time in the observation group was longer than that in the control group,with significant difference （P〈O.OS）.There was no significant difference in the amount of postpartum hemorrhage between two groups （P〉0.05）.The rate of cesarean section in the observation group was lower than that in the control group,the rate of natural delivery in the observation group was higher than that in the control group,with significant difference （P〈0.05）.There was no significant difference in the score of neonatal Apgar and neonatal behav- ioral neurological assessment analysis for 24 hours between two groups （P〉0.05）. Conclusion The analgesia effect of patient controlled epidural analgesia is good,less side effect,which can accelerate the progress of labor,especially in the active phase.PCEA can reduce the cesarean section rate,and increase the rate of vaginal delivery,which does not in- crease the complication of mothers and infants.
出处
《中国当代医药》
2015年第26期125-127,131,共4页
China Modern Medicine
关键词
自控硬膜外麻醉
分娩
镇痛
胎儿
产程
Patient controlled epidural analgesia
Delivery
Labor analgesia
fetus
Duration of labor
