论文部分内容阅读
目的探讨氢溴酸高乌甲素复合瑞芬太尼自控静脉镇痛在分娩镇痛潜伏期中的应用及对子宫收缩的影响。方法收集该院2015年1月-2016年12月在产科自愿接受分娩镇痛的足月初产妇240例为研究对象,随机分为A组(观察组):给予氢溴酸高乌甲素+瑞芬太尼分娩镇痛;B组(硬膜外组):给予硬膜外麻醉分娩镇痛;C组(对照组):未实施分娩镇痛,每组各80例,比较镇痛情况、子宫收缩情况、产程、分娩方式、新生儿等方面,并统计分析。结果与C组比较,A组、B组各时间点VAS镇痛评分明显降低,其差异有统计学意义(均P<0.05);与B组比较,A组各时间点VAS镇痛评分升高,但其差异无统计学意义(均P>0.05)。A组、B组各时间点前列腺素E2(PGE2)、皮质醇水平分别与C组差异有统计学意义(均P<0.05),但A组、B组之间的差异却无统计学意义(均P>0.05)。A组、B组、C组在各时间点的宫腔压力、宫缩间隔时间及每次宫缩持续时间及催产素水平差异无统计学意义(均P>0.05)。潜伏期、第二产程时间、分娩方式、新生儿出生1 min、5 min Apgar评分在A组、B组、C组之间的差异无统计学意义(均P>0.05),但A组活跃期明显低于B组和C组,其差异有统计学意义(均P<0.05)。结论氢溴酸高乌甲素复合瑞芬太尼自控静脉镇痛在分娩镇痛潜伏期中的应用能够取得良好的镇痛效果,且对产妇子宫收缩、催产素、分娩方式、产程时间以及新生儿等方面均无不良影响。
Objective To investigate the application of intravenous analgesia with lafentanil hydrobromide combined with remifentanil in the latent period of labor analgesia and its effect on uterine contractions. Methods A total of 240 full-term primipara from January 2015 to December 2016 in our hospital were collected and randomly divided into group A (observation group): lappaconite hydrobromide + Fentanyl labor analgesia; B group (epidural group): given epidural anesthesia labor analgesia; C group (control group): no analgesia during childbirth, each group 80 cases, compared analgesia, uterus Contractions, labor, delivery mode, newborns, etc., and statistical analysis. Results Compared with group C, the pain scores of VAS in group A and group B at each time point were significantly lower (all P <0.05). Compared with group B, the VAS analgesia score in group A at each time point was significantly higher , But the difference was not statistically significant (all P> 0.05). The levels of prostaglandin E2 (PGE2) and cortisol in group A and group B at each time point were significantly different from those in group C (all P <0.05), but there was no significant difference between group A and group B All P> 0.05). There was no significant difference in uterine pressure, contractile time, duration of uterine contractions and oxytocin level between groups A, B and C at any time point (all P> 0.05). There was no significant difference in Apgar score between A group, B group and C group at 1 min and 5 min after birth (P> 0.05), but the active phase of A group was significantly The difference was statistically significant (P <0.05). Conclusions The application of self-controlled intravenous analgesia with lafentanil hydrobromide combined with remifentanil can have a good analgesic effect in the latent period of labor analgesia. And it has a good analgesic effect on uterine contractions, oxytocin, delivery mode, delivery time and newborn No other adverse effects.