自控硬膜外麻醉分娩镇痛87例临床分析

Clinical analysis on Patient-Controlled Epidural Analgesia in treatment of 87 cases of painless delivery

目的探讨自控硬膜外麻醉(PCEA)镇痛对产妇及新生儿的影响。方法选择174例孕足月、单胎头位、无明显头盆不称、无产科并发症和合并症、胎儿监护有反应型、有阴道试产条件的初产妇,根据产妇意愿随机分为镇痛组(采用PECA)和对照组(不采用PECA),每组87例,观察镇痛效果,两组进行产程进展、剖宫产率、催产素使用率、产后出血量及胎儿窘迫、新生儿窒息情况的比较。结果分娩镇痛有效率90.8%,第1产程进展显著快于对照组(P<0.05);剖宫产率较对照组明显降低(P<0.05);催产素使用率略有增高,但差异无统计学意义(P>0.05);产后出血量略有增加,但差异无统计学意义(P>0.05);胎儿窘迫及新生儿窒息发生率无明显差异。结论使用PCEA镇痛效果确切,可促进产程进展,降低剖宫产率,对母婴无不良影响,值得推广。

【Objective】 To study the impact of patient-controlled epidural analgesia on maternal and newborn.【Methods】 174 cases of primipara with a vertex pregnancy and vaginal trial production conditions,single fetal head position,no obvious cephalopelvic disproportion without obstetric complications with fetal monitoring reactive,were randomized into two groups（the observation group and the control group） with 87 in each group.To observe the analgesic effect and to compare progress of labor,the incidence of C-sect and alpha hypophamine,the postpartum hemorrhage,fetal distress and neonatal asphyxia were observed respectively in the groups.【Results】 The efficient of pain relief is 90.8%.Compared with the control group,in the observation group,progress of first stage of labor was significantly faster（P 0.05）;fetal distress and neonatal asphyxia was no significant difference.【Conclusion】 PCEA that provided better labor analgesia,shorting duration of labor,lowing C-sect rate and having no influences on infants and mothers is for clinical use.