腰硬联合自控镇痛分娩对宫缩影响.docVIP

腰硬联合自控镇痛分娩对宫缩影响 　　【摘要】 目的 探讨腰-硬联合自控镇痛分娩对宫缩的影响,有助于更好指导镇痛分娩处理。方法 回顾性分析我院2007年4月至2008年4月采用腰-硬联合自控镇痛法分娩患者312例临床资料,并随机选择同期非镇痛分娩患者69例作对照分析。结果 312例分娩镇痛总有效率100%,发生宫缩乏力252例,发生率80.8%,使用缩宫素252例,宫缩素使用率80.8%,对照组发生宫缩乏力15例,发生率21.7%,使用缩宫素15例,宫缩素使用率21.7%,两组比较(P0.01),差异有统计学意义;镇痛组例,宫缩乏力发生在第一产程活跃期223例,占88.5%,发生在第二产程29例,占11.5%,对照组宫缩乏力发生在第一产程活跃期6例,占40%,发生在第二产程9例,占60%,两组比较P0.01,差异有统计学意义。结论 腰-硬联合自控镇痛分娩有效镇痛率达100%,但宫缩乏力发生率高,近九成宫缩乏力发生在第一产程活跃期,镇痛分娩过程中应密切监测宫缩情况,发现宫缩乏力时尽早应用缩宫素。 　　【关键词】麻醉;镇痛;宫缩乏力 　　 　　The effects on uterine contractions of labor combined Spinal-epidural analgesia 　　 　　PENG Qi-cai,XU Cheng-fang,WU Ling-ling,et al.Department of Obstetrics,the third Affilated Hospital,SUN Yat-sen University,Guangzhou 510630,China 　　【Abstract】 Objective To study the effects on uterine contractions of labor combined Spinal-epidural analgesia,help to better guide the analgesic treatment delivery.Methods A retrospective analysis of our hospital from April 2007 to April 2008 with spinal-epidural patient-controlled analgesia delivery clinical data of 312 patients and randomly selected patients over the same period 69 cases of non-analgesic delivery was calculated.Results 312 cases of analgesia was 100%,252 cases of uterine atony occurs,the incidence of 80.8%,252 cases using oxytocin,uterine prime rate 80.8%,control group,15 cases of uterine atony occurred,occurrence rate of 21.7%,use of oxytocin in 15 cases,utilization rate 21.7%,P0.01,significant difference; Analgesia group cases,uterine inertia occurred in the first stage of 223 cases of active,accounting for 88.5%,occurred in the second stage of labor in 29 cases,11.5%; in the control group produced uterine inertia occurred in the first active stage 6 cases,40%,occurred in the second stage in 9 cases,60%,respectively P0.01,significant difference.Conclusion The combined spinal-epidural analgesia and effective analgesia delivery rate of 100%,but the high incidence of uterine atony,uterine atony nearly 90 percent in the first active phase of labor