硬膜外麻醉和分娩镇痛仪行无痛分娩的临床观察

Clinical observation of epidural anesthesia and analgesia meter painless childbirth

目的探讨硬膜外麻醉和分娩镇痛仪的无痛分娩效果及对分娩方式和母婴健康的影响。方法随机抽取50例行硬膜外麻醉无痛分娩病例为A组，采用L2-L3穿刺，向头侧置管3—4cm，采用负荷量＋持续背景剂量＋患者自控硬膜外镇痛（PCEA）的给药模式；另50例镇痛仪镇痛分娩为B组。结果A组镇痛效果明显；平均宫口开全时间短，宫缩被抑制比例较高需缩宫素加强宫缩。如因某种原因改行剖宫产不需另行置管。但具有创伤性，对麻醉要求高，费用高B组只能在某种程度上缓解疼痛，不能达到完全无痛，产妇仍有宫缩感及宫缩痛，但多数VAS评分〈5，产程干预相对较少，产妇在第二产程可以主动屏气用力，显著降低阴道助产率。结论两者均有效缩短第一产程，对母婴安全；硬膜外无痛分娩较分娩镇痛仪镇痛效果显著，但阴道助产率及缩宫素干扰率也较高。

Objective Respectively epidural anesthesia and painless childbirth doula instrument to observe the average time required for the first stage of labor, oxytocin usage, delivery success rate, neonatal asphyxia, to compare the two. Methods 50 randomly selected cases of routine epidural anesthesia group A painless childbirth, using L2-L3 puncture to the head tube 3-4cm, using PCEA mode of administration; another 50 cases of group B Doula. Results A group of analgesic effect is obvious; average cervix short time, the contractions are inhibited require a higher proportion of oxytocin to strengthen contractions. Intervention group B production process is relatively small, low probability of vaginal delivery. Conclusion Epidural analgesia was significantly painless childbirth, If for any reason without prior cesarean diverted catheter. But with a traumatic, high requirements for anesthesia, the high cost of vaginal delivery rate and oxytocin interference ratio is higher. Doula instrument painless childbirth, non-invasive, inexpensive, but only to some extent alleviate the pain, but V AS s〈5, the maternal In the second stage of labor can take the initiative breath hard, significantly reducing vaginal delivery rate. Both groups have their own advantages, the need to fully communicate with the mothers, discretionary choice.