腰硬联合麻醉及硬膜外麻醉在无痛分娩中的镇痛效果及对母婴结局的影响比较

Comparison of the analgesic effect of combined spinal epidural anesthesia and epidural anesthesia in painless delivery and the influence on the outcome of mother and infant

目的比较腰硬联合麻醉(CSEA)及硬膜外麻醉(EA)在无痛分娩中的镇痛效果及对母婴结局的影响。方法将在我院行无痛分娩的200例产妇随机分为对照组(100例,EA)与观察组(100例,CSEA)。比较两组的临床效果。结果观察组的镇痛总有效率高于对照组(P<0.05)。观察组的各产程时间均短于对照组,VAS评分均低于对照组(P<0.05)。分娩后,观察组的NO、Cor、t-PA、PRL水平优于对照组(P<0.05)。观察组的泌乳总有效率高于对照组,不良妊娠率低于对照组(P<0.05)。结论CSEA在无痛分娩中镇痛效果更好,可缩短产程,减轻疼痛,减少分娩应激反应,同时提高泌乳功能,对产妇和新生儿的影响较小。

Objective To compare the analgesic effect of combined spinal epidural anesthesia(CSEA)and epidural anesthesia(EA)in painless delivery and the influence on the outcome of mother and infant.Methods A total of 200 parturients of painless delivery in our hospital were randomly divided into control group(100 cases,EA)and observation group(100 cases,CSEA).The clinical effects of the two groups were compared.Results The total effective rate of analgesia in the observation group was higher than that in the control group(P<0.05).The time of each labor stage in the observation group were shorter than those in the control group,and VAS scores were lower than those in the control group(P<0.05).After delivery,the levels of NO,Cor,t-PA and PRL in the observation group were better than those in the control group(P<0.05).The total effective rate of lactation in the observation group was higher than that in the control group,and the adverse pregnancy rate was lower than that in the control group(P<0.05).Conclusion CSEA has a better analgesic effect in painless delivery,it can shorten the labor process,reduce pain and stress response of delivery,and improve the lactation function,which has less influence on the parturient and the newborn.