腰硬联合麻醉用于分娩镇痛的临床研究

Efficacy of combined spinal and epidural anesthesia for labor analgesia

目的 :探讨腰硬联合麻醉 (CSEA)减轻或消除产痛以及对产程、胎儿、分娩方式的影响。方法 :选择 3 0 5例无产科及麻醉禁忌症的初产妇 ,在产程进入活跃早期宫口开大 3～ 4cm时 ,给予腰硬联合麻醉 (观察组 ) ,并与同期条件相似、未给予任何镇痛方法的 3 0 5例初产妇进行对比 (对照组 )。比较两组产妇产痛程度、产程进展速度、分娩方式及对胎儿的影响。结果 :观察组镇痛有效率较对照组明显升高 (P<0 .0 1 ) ,且活跃期较对照组明显缩短 ,宫颈口扩张速度加快 ,经阴道分娩助产率增高 (P <0 .0 5 )。胎儿窘迫及新生儿窒息、产后出血发生率两组则无显著的统计学意义 (P >0 .0 5 )。结论 :CSEA可有效用于分娩镇痛、加速产程 ,且对胎儿及产妇无不良影响 。

AIM: To investig at e the effects of combined spinal and epidural anesthesia (CSEA) on relieving and eliminating labor pain and the effects on newborns, labor process and delivery mode. METHODS: 305 cases without any obstetric and anesthetic co ntraindications were selected for the study group, and CSEA was applied when cer vix dilated for about 3-4 cm. 305 pregnant women with similar obstetric conditio n as control group without any anesthesia. The labor pain, duration delivery mod e and fetal status compared in the two groups. RESULTS: CSEA gro up showed good effect on relieving labor pain, shortening the active phase of la bor course, and accelerating cervical dilation. There are no different in the in cidence of fetal distress, neonatal asphyxia and postpartum hemorrhage between t wo groups. CONCLUSION: The CSEA is useful in relieving labor pai n and accelerating labor course without any side effect on fetus.