PCEA分娩镇痛对新生儿血气分析及Apgar评分的影响

Effects of patient-controlled epidural analgesia for labor on blood gas and Apgar score in newborns

目的探讨PCEA分娩镇痛对新生儿的影响。方法将200例初产妇随机分为镇痛组和对照组，每组100例。镇痛组行舒芬太尼复合罗哌卡因连续硬膜外分娩镇痛，对照组常规分娩处理。观察记录两组血压、心率、呼吸频率、脉搏及血氧饱和度，同时监测脐动脉血pH值、血氧分压（PO2）、血二氧化碳分压（PC2）、碱剩余（BE）、血乳酸含量及新生儿1-5rainApgar评分。结果两组产妇血压、心率、呼吸频率、脉搏及血氧饱和度差异无统计学意义俨〉0．05）。与对照组比较，镇痛组脐动脉血pH值、P02、PCO2、BE及新生儿1．5minApgar评分差异无统计学意义俨〉0．05），镇痛组血乳酸含量显著降低（P〈0．05）。结论PCEA分娩镇痛可以降低新生儿酸中毒及窒息的发生。

Objective To explore the effects of patient-controlled epidural anesthesia （PCEA） for labor on newborns. Methods 200 puerperas were randomly divided into an analgesia group and a control group, 100 for each group. The analgesia group received PCEA for labor with sufentanil and ropivacaine; while the control group received conventional childbirth management. Blood pressure, heart rate, respiratory rate, pulse rate, blood oxygen saturation, umbilical artery blood pH value, blood lactic acid, PO2, PCO2, and BE, and 1 - 5 min Apgar score in newborns were determined. Results Blood pressure, heart rate, respiratory rate, pulse rate, and blood oxygen saturation did not differ significantly between the two groups and the umbilical artery blood pH value, PO2, PCOz, and BE and 1 - 5 min Apgar score also did not differ statistically （P〉0.05 for all comparisons）. Contents of blood lactic acid was markedly lowered in analgesia group. Conclusions Patient-controlled epidural anesthesia for labor can reduce the occurrence of neonatal acidosis and asphyxia.