腰硬联合麻醉与硬膜外麻醉用于分娩镇痛的临床效果比较.docVIP

腰硬联合麻醉与硬膜外麻醉用于分娩镇痛的临床效果比较 　　[摘要] 目的 比较腰硬联合麻醉与硬膜外麻醉在分娩镇痛中的应用效果。 方法 选取2013年7月～2014年5月在本院实施分娩镇痛术的240例产妇作为研究对象，随机分为A组和B组，各120例。A组采用腰硬联合麻醉，B组采用硬膜外麻醉。比较两组的镇痛起效时间、运动阻滞、产程时间及新生儿Apgar评分。 结果 A组的分娩镇痛起效时间显著短于B组，VAS评分显著低于B组，差异有统计学意义（P0.05）。A组的活跃期时间显著短于B组，差异有统计学意义（P0.05）。 结论 使用腰硬联合麻醉进行分娩镇痛，可以缩短镇痛起效时间，加快产程，效果确切，安全可靠。 　　[关键词] 腰硬联合麻醉；硬膜外麻醉；分娩镇痛 　　[中图分类号] R714.3 [文献标识码] A [文章编号] 1674-4721（2015）08（b）-0107-03 　　Clinical effect comparison of combined spinal epidural anesthesia and epidural anesthesia in labor analgesia 　　ZHAI Xiao-li 　　Department of Anesthesiology，Maternal and Children′s Health Center of Luoyang City，Luoyang 471000，China 　　[Abstract] Objective To compare the clinical effect of combined spinal epidural anesthesia and epidural anesthesia in labor analgesia. Methods 240 patients implemented labor analgesia from July 2013 to May 2014 in our hospital were selected and randomly divided into group A and group B.Group A was given combined spinal epidural anesthesia，and group B was given epidural anesthesia.The analgesic effect of time，motion block，labor time and Apgar score in two groups was compared. Results The time of labor analgesia onset in group A was shorter than that in group B，the score of VAS in group A was lower than that in group B，with significant difference（P0.05）.The active period of group A was shorter than that in group B，with significant difference（P0.05）. Conclusion The use of combined spinal epidural anesthesia for labor analgesia can shorten the time of analgesia onset，speed up the production process，the effect is exact，safe and reliable. 　　[Key words] Combined spinal epidural anesthesia；Epidural anesthesia；Labor analgesia 　　分娩是一个生理过程，但是会伴随严重的疼痛。分娩疼痛是指在分娩过程中由于子宫收缩以及胎儿对产道的牵拉所造成的疼痛，常引起产妇的焦虑及恐惧等心理问题，进而导致血压升高、胎儿宫内窘迫等不良后果。分娩镇痛技术能够有效缓解分娩疼痛，保证母婴安全，其目的在于提供足够的镇痛而不会导致产妇和胎儿发生危险[1-3]。目前镇痛效果最确切的技术是硬膜外麻醉镇痛和腰硬联合麻醉镇痛。腰硬联合麻醉将脊椎麻醉与硬膜外麻醉融合为一体，具有起效快、局部麻醉药用量小及硬膜外麻醉的可连续性等优点，极大地降低了分娩镇痛的副作用，提高了镇痛质量[4-6]。本研究旨在探讨腰硬联合麻醉和硬膜外麻醉在分娩镇痛中的应用效果。 　　1 资料与方法 　　1.1 一般资料 　　选取2013年