双侧阴部神经阻滞麻醉对第二产程产妇的临床效果观察

Bilateral pudendal nerve block anesthesia clinical effect was observed on the second stage of maternal

目的分析并探讨双侧阴部神经阻滞麻醉在第二产程中应用临床效果。方法选取2013年1月至2014年1月,在我院选择经阴道分娩的初产妇240例,随机数字法分为观察组与对照组,每组120例。观察组给予双侧阴部神经阻滞麻醉,对照组则仅给予单侧阴部神经阻滞麻醉。比较2组第二产程时间和拔露至胎头娩出时间以及会阴和疼痛情况。结果观察组第二产程时间为(82±16)min,拔露至胎头娩出时间为(14±4)min。对照组第二产程时间为(92±15)min,拔露至胎头娩出时间为(18±5)min。观察组第二产程时间及拔露至胎头娩出时间均短于对照组(P<0.05)。观察组会阴完整占59.2%,会阴裂伤占29.2%,会阴侧切占11.7%。对照组会阴完整占35.8%,会阴裂伤占41.7%,会阴侧切占22.5%。观察组会阴裂伤和会阴侧切明显低于对照组(P<0.05)。观察组镇痛有效率为80.8%,对照组镇痛有效率为60.8%。观察组镇痛有效率明显高于对照组。观察组视觉模拟评分法(VAS)评分(3.2±0.8)分,对照组VAS评分(4.2±0.8)分,观察组VAS评分明显低于对照组(P<0.05)。结论双侧阴部神经阻滞麻醉能够有效的降低会阴裂伤发生率,缩短第二产程,明显减轻产妇疼痛。

Objective To analyze and discuss bilateral pudenda nerve block anesthesia clinical effect in the second stage of labor .Methods January 2013‐2014 ,when I choose vaginal delivery hospital primarily 240 cases were randomly divided into two groups and the control group ,120 cases in each group .Observation group were given bilateral pudenda nerve block anesthesia ,the control group only received unilateral pudenda nerve block an‐esthesia .The second stage of labor between the two groups exposed to the fetal head and pull out the time and cir‐cumstances of the perineum and paln. Results The second stage of labor time in the observation group was （82 ± 16）min ,exposed to the fetal head pull time （14 ± 4）min .The second stage of labor in the control group was （92 ± 15） min ,exposed to the fetal head pull time （18 ± 5） min .The second stage of labor in the observation group ex‐posed to the fetal head and pull all times shorter than the control group（ P 〈 0.05） .Observation group accounted for 59 .2% intact perineum ,perinatal laceration accounted for 29 .2% ,accounting for 11 .7% epistolary .Perineum intact control group accounted for 35 .8% ,accounting for 41 .7% of perinatal laceration ,epistolary accounted for 22 .5% .Observation group perinatal laceration and epistolary was significantly less than the control group（ P 〈0.05） .Observation group analgesic effective rate 80 .8% in the control group was 60 .8% effective analgesic .An‐algesic observation group was significantly higher efficiency .VAS score in the observation group （3 .2 ± 0 .8） points ,VAS scores in the control group （4.2 ± 0.8） points ,the observation group VAS scores were significantly lower than the control group（ P 〈 0.05） .Conclusion Bilateral pudenda nerve block anesthesia can effectively re‐duce the incidence of perinatal laceration ,shorten the second stage of labor ,significantly reduce maternal paln clinic worthy.