临床常用分娩镇痛法比较的临床研究

Comparison of Clinical Pain-relieving Methods in Delivery

目的比较目前临床常用的分娩镇痛方法的镇痛效果和对产妇及新生儿的影响,以合理选择符合分娩环境的镇痛方法减轻产妇分娩的痛苦。方法选取250例产妇随机分为产妇自控硬膜外镇痛组(PCEA组)、笑气吸入镇痛组(笑气组)、药物镇痛组(药物组)、穴位注射无菌用水组(水针组)和未给予任何镇痛措施的对照组,并分别观察五组产妇的镇痛效果、产程时间、分娩方式、产后出血量和新生儿预后等情况。结果PCEA组镇痛效果最确切,有效率98%,笑气组次之,有效率66%,药物组和水针组也有一定的镇痛效果,有效率分别为48%和36%,均明显优于对照组,五组比较,差异有显著性(χ2=273.256,P=0.000);五组各产程时间、分娩方式、产后出血量和新生儿Apgar评分均无显著性差异。结论产妇自控硬膜外麻醉,对分娩镇痛有确切的镇痛效果,对母婴无不良影响,在有条件的医院可作为分娩镇痛的首选方法,笑气吸入、药物和水针镇痛效果虽不及产妇自控硬膜外镇痛,但方法简便易行,对母儿亦无明显的副作用,可在县、乡等基层单位推广使用。

Objective To compare the present clinical pain- relieving methods in delivery, and to find a proper selection of delivery pain - relieving approach. Methods Two hundred and fifty women during delivery were randomly divided into ,5 groups, PCEA group, nitrous oxide group, analgesic drug group, acupuncture site water injection group, and placebo served as blank control group. The analgetic effect, delivery procedure, postpartum hemorrhage, childbirth way, and the newborns Apgar scores were compared and statistically analyzed. Results The effective rate of PCEA group was the best （98 % ）. The effective rate in nitrous oxide group, analgesic drug group and acupuncture site water injection group was 66 %, 48 % and 36% respectively, which was still far better than the control group, there were significant differences between the experimental groups and the control group （X^2=273. 256, P = 0. 000）. No significant difference was found among the ,5 groups on birth procedure, childbirth way, postpartum hemorrhage and the Apgar score of newborns. Conclusions PCEA has certain effects on relieving pain, which can be applied to the advanced hospitals as the first choice. The other ways of relieving pain are easy to perform and also with no significant side effect to the mothers and newborns, which can be applied to the primary hospitals and obstetric clinics.