蛛网膜下腔加双管法硬膜外联合阻滞对产程及分娩方式的影响

Influence of Intrathecal Fentanyl Combined with Double Catheter Epidural Analgesia on the Progress of Labor

目的研究联合阻滞加双管法硬膜外分娩镇痛对产妇产程、分娩方式和婴儿的影响。方法选择156例单胎、足月临产初产妇为镇痛组,行蛛网膜下腔复合双管法硬膜外镇痛。未使用镇痛的154例产妇为对照组。比较两组产妇产程时间、分娩方式、新生儿Apgar评分。结果与对照组比较,镇痛组产程时间和器械助产率无显著差异(P>0.05);剖宫产率降低,催产素使用增加(P<0.05)。结论蛛网膜下腔加双管法硬膜外联合阻滞用于分娩镇痛对产妇产程无明显影响,不增加器械助产率,减少剖宫产率,对新生儿评分无明显影响。

Objective We investigated the influence of combined spinaldouble catheter labor epidural （CSEA） technique on birth progress because of the controversy about this issue.Methods One hundred fifty six health primiparas, who wished obstetric analgesia, received intrathecal fentanyl 25 p.g combined with double catheter epidural analgesia （CSEA）. Control group included 154 cases without any analgesia. Results The duration of the first stage, the second stage and third stage in the CSEA [ （506 ± 182）min, （64 ±32）min and （ 12 ± 6）mini group did not present significantly different compared with the control group [（478 ± 210）mln, （57 ±23）mln and （11 ± 8）min]（ P 〉 0.05）. The rate of using ocytocin was higher in group CSEA than in group contro （ P 〈 0.05）. There was no difference on rate of instrumental delivery and Apgar score between two groups. The rate of caesarean section in CSEA （12.18%） group was significantly lower than in control （25.32%） group （ P 〈 0.05）. Conclusion Combined spinal - double catheter epidural （CSEA） analgesia did not affect birth progress and rate of instrttmental delivery significantly. CSEA can significandy decrease the rate of caesarean section.