硬膜外分娩镇痛对脐血血气分析影响评价

Epidural labor analgesia for evaluation of the effects of human cord blood gas analysis

目的：评价硬膜外分娩镇痛时对胎儿血气分析结果及对产程、母婴结局的影响。方法：280例产妇随机分为镇痛组和对照组：镇痛组140例，采用0．125％布比卡因，负荷量6-8ml，持续量4ml／h，产妇自控硬膜外镇痛（PCEA）；对照组140例，自然分娩者。比较两组产妇脐动、静脉血气分析、SBP、DBP、HR、Saq、总产程（第一、第二产程时间）、新生儿Apgar评分、视觉模拟评分（VAS）。结果：①两纽新生儿脐血血气分析指标测定值均在正常范围。中产程比较，差异无统计学意义；②两组产妇新生儿出生后1、5minApgar评分均为8分以上；③镇痛药起效后产妇疼痛明显减轻，宫缩时仅感腹部发紧发胀，双下肢无麻木感，活动自如。两组产妇vAS在镇痛前后差异有统计学意义（P〈0．05）。结论：0．125％布比卡因用于镇痛效果可靠，不延长产程，对新生儿无不良影响。

Objective：To evaluate the epidural labor analgesia on fetal blood gas analysis results and the impact on the labor, and outcomes. Methods：280 cases were randomly divided into maternal analgesia group and the control group： the analgesia group 140 examples, use cloth than paid 0. 125 %, 6-Sml,load to the last amount of 4 ml/h, maternal control epidural analgesia （PCEA） ;The control group, 140 cases of natural childbirth. Compare two groups of maternal umbilical venous blood gas anal- ysis and animal, SBP, DBP, HR, SaO2, total time） （first, second, the stages of labor, neonatal Apgar score, visual analogue scale（VAS）. Results： （1） two groups of neonatal umbilical cord blood index of blood gas analysis measurements were in normal range. Comparison in the stages of labor,there was no statistically significant difference; （2） two groups of maternal birth after 1,5min Apgar scores are more than eight points; （3）analgesic effect after maternal significantly reduce pain, only feeling when the contractions of my abdomen tightness, double lower limbs numbness, activities freely. Two groups of maternal VAS in pain before and after the difference was statistically significant （P〈0. 05）. Conclusion：0. 125 % cloth than paid for analgesic effect is reliable, does not extend labor, had no adverse effect on the newborn.