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目的探讨PCEA-LP与PCEA-LCP两种给药方式对产妇自控硬膜外分娩镇痛及分娩效果的影响方法选择2014年1月-2016年9月在该院进行分娩镇痛的120例产妇为研究对象,通过随机数字表法分为A组和B组,每组各60例。两组均行硬膜外导管镇痛泵自控镇痛,A组用PCEA-LP模式给药,负荷后自控量为4 ml/次,锁定时间15 min;B组用PCEA-LCP模式给药,在负荷后0.5 h,持续进行4 ml/h的输注,自控量为4 ml/次,锁定时间15 min;镇痛药物均使用0.894%的罗哌卡因和50μg的舒芬太尼。比较两组产妇各产程时间、宫口开放3 cm、5~6 cm、10 cm时视觉模拟评分(VAS)以及剖宫产、胎儿窘迫、新生儿Apgar评分≤7分和不良反应发生率。结果两组产妇在第一产程、第二产程、第三产程时间和镇痛前VAS评分方面比较差异无统计学意义(P>0.05);两组产妇宫口开放后,VAS评分较镇痛前显著降低(P<0.05),两组在宫口开放3cm、5~6cm、10cm时,VAS评分比较差异无统计学意义(P>0.05);两组产妇剖宫产、胎儿窘迫、新生儿Apgar评分≤7分发生率比较差异均无统计学意义(均P>0.05);两组产妇均无呼吸抑制、低血压、心动过缓等现象发生,A组恶心、呕吐、瘙痒、背痛总发生率明显低于B组(P<0.05)。结论 PCEA-LP和PCEA-LCP两种给药方式均具有令人满意的镇痛效果,对胎儿影响较小,PCEA-LP模式由于用药量较少,可降低不良反应发生率,安全性更高。
Objective To investigate the effects of PCEA-LP and PCEA-LCP on the analgesia and labor efficiency of maternity-controlled epidural delivery.Methods 120 maternal women who gave birth analgesia at the hospital from January 2014 to September 2016 were enrolled in this study. For the study, divided into A group and B group by random number table method, 60 cases in each group. Patients in both groups were given epidural analgesia pump for analgesia-controlled analgesia. In group A, PCEA-LP mode was used. The post-loading self-control volume was 4 ml / time and the locking time was 15 minutes. In group B, PCEA- 0.5 h after the load, continuous infusion of 4 ml / h, self-control volume of 4 ml / time, locking time 15 min; analgesics were used 0.894% ropivacaine and 50 μg of sufentanil. Visual analogue scale (VAS), open cesarean section, fetal distress, Apgar score ≤7, and incidence of adverse reactions were compared between the two groups during labor and at 3 cm, 5 to 6 cm and 10 cm respectively. Results There was no significant difference in VAS score between the two groups in the first stage of labor, second stage of labor, third stage of labor and pre-analgesia (P> 0.05) (P <0.05). There was no significant difference in VAS scores between the two groups when the cervix was open at 3cm, 5 ~ 6cm and 10cm (P> 0.05). The incidence of cesarean section, fetal distress, Apgar There was no significant difference between the two groups (P> 0.05). There was no respiratory depression, hypotension and bradycardia in the two groups. The total nausea, vomiting, pruritus and backache occurred in group A The rate was significantly lower than that of group B (P <0.05). Conclusion Both PCEA-LP and PCEA-LCP administrations have satisfactory analgesic effect and little effect on the fetus. PCEA-LP mode can reduce the incidence of adverse reactions and have higher safety due to less dosage .