摘要
目的:观察两种分娩镇痛方法对产妇第二产程镇痛效果、会阴损伤情况,比较产妇、麻醉医生、产科医生、助产士接受率。方法:选择在本院住院161例分娩产妇,随机分为硬膜外分娩镇痛组(Y组,76例)及瑞芬太尼静脉分娩镇痛+会阴阻滞组(J组,85例)。采用视觉模拟评分(VAS)评估镇痛效果,比较两组产程时间、会阴损伤情况、第二产程VAS、产妇和医护接受率。结果:(1)Ⅰ、Ⅱ度会阴裂伤率J组高于Y组,差异有统计学意义(P<0.01);Ⅲ度会阴裂伤率、阴道裂伤两组差异无统计学意义(P>0.05)。第二产程VAS分值Y组低于J组,但差异无统计学意义。(2)产妇接受率Y组低于J组(P<0.05),麻醉医生、产科医生和助产士接受率Y组高于J组(均P<0.05)。结论:硬膜外分娩镇痛较静脉分娩镇痛联合会阴阻滞能够显著减少会阴损伤,但第二产程镇痛效果两者无差异;静脉分娩镇痛产妇接受率高,而硬膜外分娩镇痛麻醉医生、产科医生和助产接受率高。
Objective： To observe the analgesic effect of two kinds of labor analgesia methods on the second stage of labor,perineal injury and its acceptance among maternity patients,anesthesiologists,obstetricians,midwives.Methods： One hundred and sixty-nine women were randomly divided into 2 groups： epidural analgesia group（ group Y,76 cases）,remifentanil intravenous labor analgesia ＋ perineum block group（ group J,85 cases）. The duration of labor,perineal injury,the second labor analgesia（ VAS）,maternal and anesthesiologist acceptance rates were compared. Results：（ 1） The rate of Ⅰ,Ⅱ degree perineal laceration was higher in group J than that in group Y（ P〈0. 01）. Ⅲ degree perineal laceration rate,vaginal laceration had no significant difference between the two group（ P〈0. 05）; second stage VAS score in group Y was lower than that in group J without significant difference.（ 2） The rate of maternal acceptance in group Y was lower than that in group J（ P〈0. 01）. The acceptance rate of anesthesiologists,obstetricians and midwifery were significantly higher in group Y than those in group J（ P〈0. 01）. Conclusion： Epidural analgesia compared with intravenous labor analgesia perineal block can significantly reduce the perineal injury,there is no significant difference of the second stage labor analgesia; intravenous labor analgesia is well accepted by maternity patients,while epidural analgesia anesthesia labor is well accepted among obstetricians and midwives.
出处
《东南大学学报（医学版）》
CAS
北大核心
2017年第4期599-602,共4页
Journal of Southeast University(Medical Science Edition)
基金
马鞍山市卫生局第十批局科教专项资金资助项目(2-1501091FH6)
关键词
瑞芬太尼
分娩镇痛
第二产程镇痛效果
接受率
remifentanil
labor analgesia
second-line analgesic effect
acceptance rate
