CAJ | 학술논문

目的：探讨应用低剂量舒芬太尼对产妇行分娩镇痛的效果。方法将90例产妇随机分为观察组、对照 I 组及对照 II 组，每组30例。3组均采用舒芬太尼镇痛，对照 I 组用量为3μg，观察组用量为5μg，对照 II 组用量为7μg。比较3组的镇痛效果、产妇分娩结局、不良反应和新生儿状态等指标。结果对照 I 组的镇痛起效时间显著长于观察组和对照Ⅱ组（P ＜0．05），首剂持续时间显著短于观察组和对照Ⅱ组（P ＜0．05）；镇痛前，3组患者的 VAS 评分无显著差异（P ＞0．05）；镇痛后30、60 min，对照Ⅰ组的 VAS 显著高于其他2组（P ＜0．05）；3组在顺产率、阴道助产率和剖宫产率方面比较无显著差异（P ＞0．05）；对照Ⅰ组和观察组患者皮肤瘙痒、恶心呕吐、嗜睡、胎心改变等不良反应的发生率均显著低于对照Ⅱ组（P ＜0．05）；对照Ⅰ组和观察组的新生儿于出生即刻的Apgar 评分显著高于对照Ⅱ组（P ＜0．05）。结论高、低剂量舒芬太尼均具有较好的分娩镇痛作用，而极低应用剂量则不能取得预期的效果。与高剂量舒芬太尼相比，低剂量舒芬太尼引发不良反应的概率较低，新生儿状态较好。
목적：탐토응용저제량서분태니대산부행분면진통적효과。방법장90례산부수궤분위관찰조、대조 I 조급대조 II 조，매조30례。3조균채용서분태니진통，대조 I 조용량위3μg，관찰조용량위5μg，대조 II 조용량위7μg。비교3조적진통효과、산부분면결국、불량반응화신생인상태등지표。결과대조 I 조적진통기효시간현저장우관찰조화대조Ⅱ조（P ＜0．05），수제지속시간현저단우관찰조화대조Ⅱ조（P ＜0．05）；진통전，3조환자적 VAS 평분무현저차이（P ＞0．05）；진통후30、60 min，대조Ⅰ조적 VAS 현저고우기타2조（P ＜0．05）；3조재순산솔、음도조산솔화부궁산솔방면비교무현저차이（P ＞0．05）；대조Ⅰ조화관찰조환자피부소양、악심구토、기수、태심개변등불량반응적발생솔균현저저우대조Ⅱ조（P ＜0．05）；대조Ⅰ조화관찰조적신생인우출생즉각적Apgar 평분현저고우대조Ⅱ조（P ＜0．05）。결론고、저제량서분태니균구유교호적분면진통작용，이겁저응용제량칙불능취득예기적효과。여고제량서분태니상비，저제량서분태니인발불량반응적개솔교저，신생인상태교호。
Objective To explore the effect of low dose sulfentanyl on labor analgesia. Methods 90 puerperas were randomly divided into observation group,control group I and control group Ⅱ,30 cases in each group.Sulfentanyl was used for labor analgesia in all the groups.The dose of sulfentanyl in the control group Ⅰ,the observation group and control group Ⅱ were 3 μg, 5 μg and 7μg respectively.Indexes such as analgesic efficacy,maternal birth outcomes,adverse re-actions and neonatal state were compared among three groups.Results The onset time of analge-sia in the control group Ⅰ was significantly longer than that in the observation group or the control group Ⅱ (P <0.05),while the first agent duration was significantly shorter than that in the ob-servation group or the control group Ⅱ (P <0.05);before the analgesia,there was no significant difference of VAS score among three groups (P >0.05);at the time of 30 and 60 minutes after analgesia,the VAS score of the control group I was significantly higher than that of the other two groups (P <0.05);there were no significant differences of the vaginal delivery rate,assistant vaginal delivery rate and cesarean section rate among the three groups (P >0.05);the incidence rates of the adverse reactions such as pruritus,nausea and vomiting,lethargy and fetal heart changes of the women in the control group Ⅰ and the observation group were significantly lower than those in the control group Ⅱ (P <0.05);the Apgar scores of the neonates in the control group Ⅰ and the observation group were significantly higher than that in the control group Ⅱ (P<0.05).Conclusion Efficacy of high or low dose sulfentanyl for labor analgesia is similar,while a very low dose sulfentanyl can not achieve the desired results.Compared with a high dose sulfen-tanyl,the adverse reactions probability induced by a low dose sufentanil is low and the neonatal state is better.