硬膜外自控镇痛用于无痛分娩的临床效果观察

Clinical effect observation of patient controlled epidural analgesia for painless labor

目的 探讨硬膜外自控镇痛用于无痛分娩的临床效果.方法 选取本院2012年3月～2013年3月接诊的386例足月待分娩的产妇,将其随机分为对照组与实验组,每组各193例.对照组实行常规分娩并且未采取任何镇痛措施；实验组采取硬膜外自控镇痛的无痛分娩方式,比较两组产妇分娩过程中的疼痛程度、分娩方式、胎儿窘迫和新生儿窒息情况.结果 实验组：186例（96.37％）表现为无痛及轻微疼痛,对照组：169例（87.56％）表现为中度疼痛,两组的四类疼痛程度比较,差异有统计学意义（P＜0.05）；实验组的顺产比例高于对照组,阴道助产、剖宫产比例明显低于对照组,胎儿窘迫及新生儿窒息的发生率均显著低于对照组（P＜0.05）.结论 硬膜外自控镇痛的无痛分娩可以有效降低产妇在分娩过程中出现的疼痛程度,增加新生儿顺产的概率,降低胎儿窘迫及新生儿窒息的发生率,是一种较为理想的分娩镇痛方法,具有极大的临床使用价值,值得推广.

Objective To explore the clinical effect of patient controlled epidural anesthesia for painless labor. Meth- ods 386 puerperaes of full term for delivery in our hospital from March 2012 to March 2013 were selected and ran- domly divided into the control group （n=193） and the experimental group （n=193）. In the control group,the convention- al delivery without any anesthetic measures was applied while in the experimental group,the mode of patient controlled epidural anesthesia for painless labor was adopted.The pain degree during birth process,delivery mode,the occurrence rate of fetal distress and neonatal asphyxia in the two groups were compared. Results In the experimental group, 186 puerperaes （96.37%） presented with no pain or slight pain during labor while in the control group,169 puerperaes （87.56%） were in moderate pain.There were significant differences in 4 grades of pain degrees in both groups （P〈0.05）. The proportion of eutocia in the experimental group was higher than that of the control group,and the proportion of as- sisted vaginal delivery and caesarean section in the former were greatly lower than those in the latter.The incidence of fetal distress and neonatal asphyxia in the experimental group were lower than those in the control group （P〈0.05）. Conclusion Patient controlled epidural anesthesia for painless labor can effectively alleviate the pain degrees during birth process,increase possibility of eutocia and reduce the incidence of fetal distress and neonatal asphyxia.It is an ideal anesthetic approach during delivery and has great clinical value and it is worthy of promotion.