CAJ | 학술논문

目的：对自控硬膜外麻醉背景剂量是否存在对镇痛效果和分娩结局的影响进行分析,探讨更有益于产妇和新生儿的麻醉方式。方法选取100例于我院自然分娩产妇为资料,随机等分为采用有背景剂量自控硬膜外麻醉的观察组和采用无背景剂量硬膜外麻醉的试验组,每组50人,以6 mL/h为背景剂量。麻醉后对产妇进行VAS评分,统计对比两组产妇生产前后发生的不良反应,以及其分娩方式,此外还对新生儿进行Apgar评分,并统计对比两组产妇用药量。结果两组产妇均未发生较为严重的不良反应,不良反应发生率对比未出现显著差异,试验组产妇中有36例患者机械助产,14例患者行剖宫产,观察组则分别为34例16例,分娩方式差异不显著。试验组产妇呼吸频率、心率以及血氧饱和度等血气指标略高于观察组,差异不显著,进行VAS评分,所有产妇均达到较好麻醉效果,无不耐受疼痛出现,产后5 min对新生儿进行Apgar评分,无低于4分新生儿出现,试验组和观察组两组新生儿平均评分分别为(7.52依2.12)和(7.61依2.56),差异不显著(P>0.05)。结论无论是有背景剂量还是无背景剂量的硬膜外麻醉都可以对产妇产生较好麻醉效果,无背景剂量麻醉可能导致产妇血气指标产生相对较大波动,有背景剂量麻醉则可能造成更高的过敏反应,总体而言应根据产妇麻药耐受性选择麻醉方式。
목적：대자공경막외마취배경제량시부존재대진통효과화분면결국적영향진행분석,탐토경유익우산부화신생인적마취방식。방법선취100례우아원자연분면산부위자료,수궤등분위채용유배경제량자공경막외마취적관찰조화채용무배경제량경막외마취적시험조,매조50인,이6 mL/h위배경제량。마취후대산부진행VAS평분,통계대비량조산부생산전후발생적불량반응,이급기분면방식,차외환대신생인진행Apgar평분,병통계대비량조산부용약량。결과량조산부균미발생교위엄중적불량반응,불량반응발생솔대비미출현현저차이,시험조산부중유36례환자궤계조산,14례환자행부궁산,관찰조칙분별위34례16례,분면방식차이불현저。시험조산부호흡빈솔、심솔이급혈양포화도등혈기지표략고우관찰조,차이불현저,진행VAS평분,소유산부균체도교호마취효과,무불내수동통출현,산후5 min대신생인진행Apgar평분,무저우4분신생인출현,시험조화관찰조량조신생인평균평분분별위(7.52의2.12)화(7.61의2.56),차이불현저(P>0.05)。결론무론시유배경제량환시무배경제량적경막외마취도가이대산부산생교호마취효과,무배경제량마취가능도치산부혈기지표산생상대교대파동,유배경제량마취칙가능조성경고적과민반응,총체이언응근거산부마약내수성선택마취방식。
Objective To analyze the effect of self-control background dose epidural anesthesia, and to explore a more conducive way for maternal and newborn infants. Methods 100 cases of natural childbirth in our hospital were selected and randomly divided into the observation group with background dose of self-control epidural anesthesia and the test group without background dose of epidural an-esthesia. There were 50 people in each group, with 6 mL/h as the background dose. Those parturient women were evaluated by VAS score after anesthesia, the adverse reaction and the delivery mode of the two groups were compared before and after the maternal produc-tion. Furthermore, the new born infants were given neonatal Apgar test, and the maternal dose of the two groups of was compared. Re-sults There were no adverse reactions in the two groups, and there were no obvious differences in terms of the incidence of adverse reac-tions. In the test group, there were 36 cases of mechanical midwifery and 14 cases of cesarean section. In the observation group, the number was 34 and 16 respectively. The mode of delivery was not significantly different. In the test group, the blood gas indexes, such as the breathing rate, heart rate and blood oxygen saturation, were higher than those of the observation group, and there were no significant differences. After VAS score, all the parturient women achieved good anesthetic effect without pain tolerance. The newborn infants were evaluated by Apgar score 5 minutes after delivery, in which there were no infants under 4 points. The neonatal average score of the two groups were (7.52±2.12) and (7.61±2.56) respectively. The difference was not obvious (P>0.05). Conclusion The Epidural an-esthesia, with or without background dose, can both achieve good anesthesia effect to parturient women. Epidural anesthesia without background dose can lead to relatively large fluctuations to maternal blood gas index, while anesthesia with background dose may lead to high allergic reactions. To sum up, the pattern of anesthesia should be chosen according to maternal anesthetic tolerance.