CAJ | 학술논문

目的：探讨瑞芬太尼静脉自控麻醉应用于产妇分娩中的镇痛效果及产生的不良反应。方法：将经笔者所在医院检查适于阴道分娩并愿意接受麻醉镇痛的60例足月健康初产妇作为实验研究对象。将采用瑞芬太尼静脉自控镇静麻醉的30例产妇作为观察组，将采用硬膜外阻滞自控镇痛麻醉的30例产妇作为对照组。比较两组产妇不同镇痛方式下的镇痛效果、各产程时间、不良反应发生率、器械助产率、剖宫产率、催产素使用率。比较两组新生儿Apgar评分。结果：两组产妇的镇痛效果、剖宫产率、催产素使用率比较差异无统计学意义(P>0.05)。观察组产妇的第一产程和第二产程明显小于对照组(P<0.05)；观察组产妇在镇痛过程有困倦情况发生，镇静程度高于对照组(P<0.05)；其低血氧饱和度发生率高于对照组(P<0.05)，其他不良反应发生率两组相似；对照组产妇的器械助产率更高，与观察组比较差异有统计学意义(P<0.05)。两组新生儿Apgar评分相似。结论：瑞芬太尼静脉自控镇痛麻醉虽然存在不良反应但均可缓解，对孕妇和胎儿不会造成影响，可以用于产妇的分娩镇痛中。
목적：탐토서분태니정맥자공마취응용우산부분면중적진통효과급산생적불량반응。방법：장경필자소재의원검사괄우음도분면병원의접수마취진통적60례족월건강초산부작위실험연구대상。장채용서분태니정맥자공진정마취적30례산부작위관찰조，장채용경막외조체자공진통마취적30례산부작위대조조。비교량조산부불동진통방식하적진통효과、각산정시간、불량반응발생솔、기계조산솔、부궁산솔、최산소사용솔。비교량조신생인Apgar평분。결과：량조산부적진통효과、부궁산솔、최산소사용솔비교차이무통계학의의(P>0.05)。관찰조산부적제일산정화제이산정명현소우대조조(P<0.05)；관찰조산부재진통과정유곤권정황발생，진정정도고우대조조(P<0.05)；기저혈양포화도발생솔고우대조조(P<0.05)，기타불량반응발생솔량조상사；대조조산부적기계조산솔경고，여관찰조비교차이유통계학의의(P<0.05)。량조신생인Apgar평분상사。결론：서분태니정맥자공진통마취수연존재불량반응단균가완해，대잉부화태인불회조성영향，가이용우산부적분면진통중。
Objective:To investigate the adverse reaction and childbirth analgesia effect of patients controlled intravenous anesthesia Remifentanil for maternity.Method:60 cases of early maternal health in hospital after checking apply to vaginal delivery and willing to accept the term narcotic analgesic were as experimental subjects.The controlled intravenous sedation using Remifentanil anesthesia in 30 women were as the observation group,epidural analgesia anesthesia 30 women served as control group.Analgesia analgesia were compared under different mothers,each labor time,incidence of adverse reactions,instrumental delivery rate,cesarean rate,oxytocin usage,Apgar score were compared.Result:The two groups of maternal analgesia,cesarean rate,oxytocin usage were similar,the differences were no significant difference(P>0.05).Maternal first stage and second stage of labor in the observation group were significantly less than those in the control group(P<0.05);observation group maternal analgesia drowsiness occurs,the degree of sedation was higher in the observation group than that in the control group(P<0.05);the incidence of oxygen saturation was higher in the observation group than that in the control group(P<0.05),other adverse reactions were similar incidence,mothers instrumental delivery rate in the control group was higher than that in the observation group(P<0.05).Apgar score was similar in two groups.Conclusion:PCIA Remifentanil anesthesia although has side effects,but it can relieve,pregnant women and the fetus will not be affected,can be used for labor analgesia in women.