硬膜外分娩镇痛的临床研究

Clinical study on labor pain relief by epidural analgesia

目的 :探讨硬膜外分娩镇痛效果及其对产程、母婴状况的影响。方法 :将 0 1%布比卡因及芬太尼 5 μg/ml混合液硬膜外分娩镇痛的 30 0例产妇作为镇痛组 ,将未用任何镇痛药的 30 0例产妇作为对照组 ,比较两组的产痛程度、产程时间、分娩方式、产后出血量、羊水粪染率、新生儿窒息及缩宫素应用等。结果 :镇痛组 30 0例产妇中显效 90 33% (2 71/30 0 ) ,有效 9 6 7% (2 9/30 0 ) ,总镇痛有效率 10 0 % ;镇痛组的活跃期和第二产程时间短于对照组 ,差异有显著性意义 (P <0 0 1) ;镇痛组自然分娩率明显高于对照组 (P <0 0 5 ) ,剖宫产率则以对照组为高 (P <0 0 5 ) ;两组羊水粪染率、新生儿窒息、Apgar评分、产后出血量及缩宫素应用的比较无显著性差异 (P <0 0 5 )。结论 :硬膜外分娩镇痛是一种理想的、安全有效的分娩镇痛方法。

Objective To study the effect of epidural analgesia with bupivacaine on labor pain relief and conditions of the mothers and neonates. Methods:Parturients received epidural analgesia with 0.1% bupivacaine and Fentanyl 5 μg/ml were assigned to Group A(n=300) , while parturients without analgesia were assigned to Group B(n=300). The degree of labor pain relief, duration of labor,mode of delivery,oxytocin use and the rate of occurrence of meconium-strained amniotic fluid, and neonatal Apgar score were measured. Results: Group A showed perfect effect of analgesia on labor pain relief in 271 parturients (90.33%), and good effect in 29 parturients (9.67%). The total tate of labor pain relief was 100%; The duration ofactive phase and second-stage labor in Group A was shorter than in Group B( P <0.01);Group A showed a high rate of natural delivery ( P <0.05) and a lower rate of cesarean section ( P <0.05). No difference was observed in Apgar score or in the occurrence of rate of meconium-stained amniotic fluid,postpartum haemorrhage and oxytocin use. Conclusion:Epidural analgesia with bupivacaine is safe and effective for labor pain relief.