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目的:探讨硬膜外阻滞麻醉用于分娩镇痛的效果及对产程、母婴的影响。方法:观察组140例单胎头位初产妇于宫口开大3cm时行硬膜外麻醉,首剂注入0.2%盐酸罗哌卡因+芬太尼(2μm/mL)8ml,之后接装有0.2%盐酸罗哌卡因+芬太尼(2μm/mL)的自控镇痛泵(PCA),4ml/h;对照组随机抽取同期未使用镇痛药物的单胎头位初产妇140例。观察两组镇痛效果、产程时间、催产素使用情况、分娩方式、产后出血、新生儿窒息情况。结果:两组间VAS疼痛分级差异明显,观察组第一产程活跃期比对照组明显缩短(P<0.01),且催产素的使用率明显高于对照组(P<0.01)。而两组分娩方式、新生儿窒息、产后出血比较差异均无统计学意义。结论:硬膜外阻滞麻醉用于分娩镇痛效果确切,可缩短第一产程,不影响母婴结局。
Objective: To investigate the effect of epidural anesthesia on labor analgesia and its effects on labor and maternal and infant. Methods: In the observation group, 140 primiparous primiparous women received epidural anesthesia during the first 3cm of cervix. The first dose of 0.2% Ropivacaine hydrochloride plus fentanyl (2μm / mL) Controlled analgesia pump (PCA) 0.2% ropivacaine hydrochloride + fentanyl (2μm / mL), 4ml / h; control group randomly selected 140 cases of primiparous single head fetus without analgesics. The analgesic effect, labor duration, oxytocin use, mode of delivery, postpartum hemorrhage and neonatal asphyxia were observed. Results: There was significant difference in the grading of VAS between the two groups. The active phase of the first stage of labor in the observation group was significantly shorter than that in the control group (P <0.01), and the oxytocin utilization rate was significantly higher than that in the control group (P <0.01). However, there was no significant difference between the two modes of delivery, neonatal asphyxia and postpartum hemorrhage. Conclusion: Epidural anesthesia is effective in analgesia during labor and can shorten the first stage of labor without affecting the outcome of mother-infant.