CAJ | 학술논문

目的：观察静脉输注瑞芬太尼复合硬膜外阻滞用于分娩镇痛的临床效果和安全性。方法：选择足月初产妇60例，随机分为硬膜外镇痛组（ E组）和瑞芬太尼复合硬膜外镇痛组（ R组），每组30例。E组宫口开至3 cm时行硬膜外阻滞分娩镇痛。R组在硬膜外给药同时静脉泵入瑞芬太尼，泵注剂量0.05μg/（ kg·min）。记录镇痛前及镇痛后各时间点产妇视觉模拟评分法（ VAS）的评分；记录产程时间、剖宫产率、器械助产率、缩宫素使用率；记录新生儿Apgar评分，同时抽取脐动脉血行血气分析；观察分娩过程中的不良反应。结果：R组镇痛后各时间点VAS评分均低于E组，差异有统计学意义（ P<0.05）；两组产妇产程时间、剖宫产率、器械助产率、缩宫素使用率、新生儿Apgar评分、脐动脉血气分析及分娩过程中不良反应发生率比较差异均无统计学意义（ P>0.05）。结论：静脉输注瑞芬太尼可以明显改善硬膜外阻滞分娩镇痛的镇痛效果，并不增加其不良反应的发生。
목적：관찰정맥수주서분태니복합경막외조체용우분면진통적림상효과화안전성。방법：선택족월초산부60례，수궤분위경막외진통조（ E조）화서분태니복합경막외진통조（ R조），매조30례。E조궁구개지3 cm시행경막외조체분면진통。R조재경막외급약동시정맥빙입서분태니，빙주제량0.05μg/（ kg·min）。기록진통전급진통후각시간점산부시각모의평분법（ VAS）적평분；기록산정시간、부궁산솔、기계조산솔、축궁소사용솔；기록신생인Apgar평분，동시추취제동맥혈행혈기분석；관찰분면과정중적불량반응。결과：R조진통후각시간점VAS평분균저우E조，차이유통계학의의（ P<0.05）；량조산부산정시간、부궁산솔、기계조산솔、축궁소사용솔、신생인Apgar평분、제동맥혈기분석급분면과정중불량반응발생솔비교차이균무통계학의의（ P>0.05）。결론：정맥수주서분태니가이명현개선경막외조체분면진통적진통효과，병불증가기불량반응적발생。
Objective To observe the clinical effect and safety of intravenous remifentanil combined with epidural block for labor anal-gesia. Method Sixty full-term Primipara were randomly divided into two groups(n=30):group E and group R. In group E,the parturients were given epidural analgesia when when cervical dilatation reached 3 cm;in group R,0. 05μg( kg·min)remifentanil were contious intra-venous infused at the beginning of epidural analgesia. Visual analogue scale( VAS)was used to record pain scores before analgesia and at different time points after analgesia;the duration of labor,incidence of caesarean delivery,instrumental vaginal delivery and oxytocin admin-istration ,neonatal Apgar scores ,umbilical cord arterial blood gas parameters and side effects of analgesia were recor-ded. Results Compared with group E,the VAS score were decreased in group R at every time points after analgesia(P<0. 05). There were no significant difference between the two groups in the duration of labor,incidence of caesarean delivery、instrumental vaginal delivery and oxytocin administration ,neonatal Apgar scores ,umbilical cord arterial blood gas parameters and side effects of analgesia(P>0. 05). Con-clusion Intravenous infusion of remifentanil can improve analgesia effect of Epidural Analgesia for Labor and does not increase the inci-dence of its side effects.