产程潜伏期与活跃期行腰-硬联合麻醉分娩镇痛的临床效果对比

李辉霞，胡灼军

（安康市人民医院，陕西 安康，725000）

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摘要：

目的 探讨产程潜伏期与活跃期行腰-硬联合麻醉分娩镇痛的临床效果。方法 收集在我院2015 年1 月至2017 年1 月自 愿接受腰-硬联合麻醉分娩镇痛的产妇100 例，随机分为观察组和对照组，每组50 例。观察组在产程潜伏期使用腰-硬联合麻 醉分娩镇痛，对照组在产程活跃期使用腰-硬联合麻醉分娩镇痛，使用VSA 疼痛视觉模拟评分评估镇痛效果，比较两组产妇分 娩镇疼VAS 评分，产后产妇和新生儿情况。结果 镇痛前两组VAS 评分无显著差异（P>0.05）。对照组在宫口扩张7～8 cm 时VSA 评分略低于观察组（P>0.05），其余时间均高于观察组（P<0.05）；两组产妇第二产程时间及新生儿出生后5 min Apgar 评分无显 著差异（P>0.05）；第一产程时间对比上，观察组产妇显著短于对照组（P<0.05）。结论 产妇分娩过程中，在产程的潜伏期使用腰-硬 联合麻醉方法进行分娩镇痛，能将运动阻滞降到最低，减少对产程的影响，缩短第一产程时间，降低剖宫产率，应在临床中广泛使用。

关键词：产程；潜伏期；活跃期；腰-硬联合麻醉；分娩镇痛

中图分类号：R614文献标志码：A文章编号：2096-1413(2018)06-00131-02

Clinical effects comparison of combined spinal-epidural anesthesia on labor analgesia during incubation period and active period of birth
LI Hui-xia, HU Zhuo-jun
(the People``s Hospital of Ankang, Ankang 725000, China)

ABSTRACT: Objective To investigate the clinical effect of combined spinal-epidural anesthesia in the treatment of labor analgesia during incubation period and active period of birth. Methods One hundred cases of puerperas with voluntarily accepted combined spinal-epidural anesthesia in the treatment of labor analgesia from January 2015 to January 2017 in our Hospital were selected, and randomly divided into observation group and control group, with 50 cases in each group. The control group was given combined spinal-epidural anesthesia during incubation period of birth. The observation group was given combined spinal-epidural anesthesia during active period of birth. The analgesic effects were evaluated by VSA pain visual analogue scale and the meternals and newborns outcomes of the two groups were compared. Results There was no significant difference in the VAS scores between the two groups before analgesia (P>0.05). The VSA score of the control group at 7-8 cm of uterine enlargement was slightly lower than that in the observation group (P>0.05). The scores of other time of the control group were higher than those in the observation group （P<0.05）. There were no statistically significant differences in the second stage of labor and the Apgar scores in neonate after 5 minutes of the two groups (P>0.05); the first stage of labor in the observation group was shorter than that of the control group（P<0.05）. Conclusion During the maternaln delivery, combined spinal-epidural anesthesia during incubation period can relieve the pain of labor during childbirth and reduce the effect of the movement block. It can shorten the first labor time and reduce the cesarean section rate, which is worthy of clinical application and popularization.
KEYWORDS: birth process; incubation period; active period; combined spinal-epidural anesthesia; labor analgesia

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