摘要
目的 了解腰麻 -硬膜外联合麻醉和产妇自控硬膜外镇痛 (CSEA +PCEA)是否对产程进展存在影响。方法 回顾性分析 2 0 0 2年 3月~ 8月 5 0 7例阴道分娩健康初产妇病历资料 ,观察组 (CSEA +PCEA)共2 5 9例 ,对照组 (未采用CSEA +PCEA) 2 4 8例 ,通过产程图比较两组产程进展。结果 观察组第一产程活跃期及第二产程时间分别为 (2 71 93± 12 7 4 4 )min和 (5 7 39± 35 5 2 )min ,较对照组活跃期 (188 0 8± 110 2 9)min及第二产程时间 (44 84± 31 92 )min延长 (P <0 0 0 1) ;观察组产程图宫口曲线较Friedman产程图倾斜角度较小 ,即活跃期进展较慢 ,平均每小时宫口开大 1 5cm。结论 腰麻及硬膜外联合镇痛后活跃期进展减慢 ;镇痛后的产程处理不应单纯按照传统Friedman产程图。CSEA +PCEA不适宜作为理想的分娩镇痛方式。
Objective To study whether combined spinal-epidural analgesia(CSEA) and patient-control epidural analgesia (PCEA) has influence on labor progress. Methods Retrospective study was made on 507 healthy vaginal delivery nulliparas from March to August at 2002 in department of Obstetric and Gynecology, first hospital of Beijing University to study the partogram. Study group (259 cases) receipted CSEA+PCEA and control group (248 cases) didn't. Results The time of active phase of labor and second stage of study group prolonged than that of control group[(271.93±127.44)min and (188.08±110.29)min, (57.39±35.52 )min and(44.84±31.92) min](P<0.001). The cervix curve ascended more slowly than Friedman curve and the cervix dilated 1.5cm each hour averagely in the active phase.Conclusions CSEA+PCEA had adverse effect on labor progress and wasn't ideal obstetric anesthesia. The labor management shouldn't just be based on Friedman partogram.
出处
《中国妇产科临床杂志》
2005年第1期32-34,共3页
Chinese Journal of Clinical Obstetrics and Gynecology