分娩期吸入氧化亚氮镇痛对母婴影响临床分析.docVIP

分娩期吸入氧化亚氮镇痛对母婴影响临床分析 　【关键词】 分娩 　　【摘要】 目的 探讨分娩期吸入氧化亚氮镇痛方法对产妇及新生儿的影响。 方法 280例无合并症及并发症的初产妇，在宫口开大3cm时，吸入氧化亚氮开始进行分娩镇痛，设为镇痛组;250例同期相同条件的产妇设为对照组。对两组产程、产后出血量、剖宫产率、新生儿Apgar评分、新生儿高胆红素血症发生率、产后泌乳情况进行比较。 结果 镇痛组新生儿Apgar评分、新生儿高胆红素血症发生率、产后泌乳、产后出血量和与对照组比较差异无显著性。产程进展显著快于对照组，剖宫产率显著低于对照组。 结论 氧化亚氮作为分娩镇痛，具有对母婴影响小、易于给药、起效快、作用可靠、产妇清醒、不影响宫缩等优点，值得在临床推广应用。 　　关键词 分娩 镇痛 　　Effects of analgetic nitrous oxide during delivery on maternal and infants 　　【Abstract】 Objective To detect the effect on pregnant and neonatal by nitrous oxide inhalation during deliv-ery.Methods 280cases of primipara with no complication was as study group，they used nitrous oxide when cervical os enlarged by3cm during delivery，250cases pregnant with the same condition was as control groups，two groups were compared with the labor stage，postpartum hemorrhage rate，caesarean-section rate，neonatal Apgar score，hyperbiliru-binemia rate，postpartum breast secreting rate.Results There were no difference in postpartum hemorrhage rate，neonatal Apgar score，neonatal hyperbilirubinemia rate，postpartum breast secreting rate between two groups，but the la-bor stage study group was significant faster than that of control group.The caesarean-section rate was marked lower in study group than that of control group.Conclusion The analgetic effect by nitrous oxide during delivery was less ef-feet to maternal and neonatal，easy to give drug，the effect more quickly and with reliable effects.The prenatalls kept clear head，and with no effect to uterine contraction.The analgetic method was worth application in clinical. 　　Key words labor analgetic 　　在欧美国家约25%的医院，原则上全部产妇实行无痛分娩 ［1］ ;在我国，随着人们生活水平的提高，产妇无痛分娩的要求也开始逐渐增多，而无痛分娩一直是妇产科医务工作者追求的目标。我院从2001年开始采用50%氧化亚氮（笑气）+50%氧气进行分娩期的镇痛，取得较为满意的效果。现对其产程进展、产后出血量、最终分娩方式、产后泌乳、新生儿情况进行临床分析。 　　1 资料与方法 　　1.1 一般资料 选择2001年6月～2003年12月间，我院足月分娩初产妇280例，单胎头位，无头盆不称，心肺功能正常，宫口开大3cm，无妊娠期合并症和并发症，要求分娩镇痛者为镇痛组;选择同期相同条件的产妇250例作为对照组。 　　1.2 方法 镇痛组在宫口开大3cm，用50%氧化亚氮+50%氧气的混合气体，当宫缩来临，子宫收缩痛产生之前30～50s，将面罩紧贴鼻部，深吸止痛混合气体3～4次，再松开面罩，如此反复，直