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目的:探讨硬膜外阻滞镇痛的分娩效果及对母婴的影响。方法:采用回顾性研究方法。200例初产妇根据分娩镇痛情况分为两组,观察组100例宫口开大2~3 cm时于第2~3腰椎硬膜外穿刺并置管,首次注入0.075%盐酸罗哌卡因+舒芬太尼10 ml,之后予0.075%盐酸罗哌卡因+舒芬太尼自控镇痛泵持续给药6~8 ml·h-1,宫口近开全停止给药。对照组100例宫口开大2~3 cm时不使用任何麻醉药物。观察比较两组产妇镇痛效果,产程时间及分娩方式、产后出血量、胎儿窘迫、产后出血情况。结果:观察组镇痛有效率97.0%,明显高于对照组的10.0%(P<0.05);观察组第一产程时间明显短于对照组(P<0.05),阴道助产率明显低于对照组(P<0.05)。两组新生儿窒息发生率和1 min Apgar评分,以及患者产后24 h出血量及出血率等比较,差异均无统计学意义(P>0.05)。结论:低浓度罗哌卡因联合舒芬太尼硬膜外阻滞用于分娩镇痛,有较好镇痛效果,可缩短产程时间,促进分娩顺利进行。
Objective: To investigate the effects of epidural analgesia on labor and maternal and childbirth. Methods: A retrospective study was conducted. 200 primiparous women were divided into two groups according to labor analgesia. 100 cases of observation group received epidural puncture and catheterization of 2 ~ 3 lumbar vertebrae at 2 ~ 3 cm. The first injection of 0.075% ropivacaine hydrochloride + Sufentanil 10 ml, followed by 0.075% ropivacaine hydrochloride + sufentanil self-controlled analgesia pump continuous administration of 6 ~ 8 ml · h-1, cervix nearly all open to stop administration. The control group of 100 cases of cervix open 2 ~ 3 cm do not use any anesthetic drugs. Observe and compare analgesic effect, labor time and mode of delivery, postpartum hemorrhage, fetal distress and postpartum hemorrhage in two groups. Results: The effective rate of analgesia in the observation group was 97.0%, which was significantly higher than that in the control group (P <0.05). The time of the first stage of labor in the observation group was significantly shorter than that in the control group (P <0.05) Group (P <0.05). There was no significant difference in the incidence of asphyxia, 1-minute Apgar score, 24-hour postpartum hemorrhage and bleeding rate between the two groups (P> 0.05). Conclusion: Low concentration of ropivacaine combined with sufentanil epidural block for labor analgesia, analgesic effect is good, can shorten the labor time and promote the smooth progress of delivery.