硬膜外镇痛联合导乐陪伴在全程分娩中的应用

Application of epidural analgesia combined with doula in labor

目的评估硬膜外镇痛联合导乐陪伴(助产士陪伴)用于全程分娩的效果。方法300例初产妇进入产程潜伏期后实施分娩镇痛联合导乐陪伴(A组)、单用分娩镇痛(B组)和单用导乐陪伴(C组),每组100例。记录镇痛效果(VAS)、神经阻滞评分(MBS)、满意度评分、产程、分娩方式、催产素的使用、新生儿Apgar评分及不良反应。结果A和B组镇痛后30minVAS评分显著低于镇痛前[(0.9±0.6)分和(1.0±0.5)分vs.(7.6±1.2)分和(7.4±1.4)分](P<0.01)。A组产妇满意度显著高于B组和C组[(98.2±3.0)分vs.(85.2±5.8)分和(83.6±6.1)分](P<0.05)。A组及C组第一、二产程均短于B组(P<0.05)。结论硬膜外镇痛联合导乐陪伴用于分娩全程,镇痛效果确切,并可缩短产程。

Objective To evaluate the outcomes of epidural analgesia combined with doula （accompanied by midwife） for labor analgesia. Methods Three hundred nulliparous parturients were assigned to three groups with 100 cases each. Epidural analgesia combined with doula was used in group A, epidural analgesia alone in group B and doula alone in group C. The visual analogue scale （VAS） ,modified Bromage score （MBS）, maternal satisfaction, duration of labor, mode of deliveries, oxytocin consumption and neonatal Apgar score were recorded. Results VAS scores in group A and B were significantly lower at 30 min during analgesia than those before [ （0. 9 ± 0. 6）scores and （1.0 ± 0.5）scores vs. （7.6±1.2） scores and（7.4± 1.4） scores]（P〈0.01）. The maternal satisfaction score was significantly higher in group Athan that in group B or group C[（98. 2±3.0）scores vs. （85.2± 5.8）scores or（83.6±6.1）scores] （P〈0.05）. Duration of the first and second stages in group A and C was significantly shorter than that in group B（P〈0.05）. Conclusion The epidural analgesia combined with doula for labor analgesia can provide effective analgesia and shorten the labor course.