CAJ | 학술논문

目的观察甲磺酸罗哌卡因复合苏芬太尼用于硬膜外阻滞可行走分娩镇痛的效果.方法选择接受0.12％甲磺酸罗哌卡因复合苏芬太尼(0.5μg/ml)硬膜外镇痛的360例产妇作为镇痛组,在同期条件相似未行镇痛的356例产妇为对照组.采用视觉模拟评分(VAS)评估宫缩时疼痛,改良Bromage评分评估下肢运动阻滞,记录镇痛效果、产程时间、分娩方式、产后出血、胎儿窘迫和新生儿Apgar评分情况.结果镇痛组较对照组在镇痛后30 min、宫口开全、胎儿娩出时疼痛明显缓解,活跃期缩短,阴道顺产率高,剖宫产率低(t=31.989、39.586、35.893、-12.382,x2=34.685、36.854,均P＜0.05)；两组第二产程、第三产程时间和阴道助产率、缩宫素使用率、新生儿窒息发生率差异均无统计学意义(均P＞0.05).结论甲磺酸罗哌卡因复合苏芬太尼硬膜外阻滞分娩镇痛效果确切、安全,无运动神经阻滞,不影响产程及新生儿,可降低剖宫产率.
목적 관찰갑광산라고잡인복합소분태니용우경막외조체가행주분면진통적효과.방법 선택접수0.12％갑광산라고잡인복합소분태니(0.5μg/ml)경막외진통적360례산부작위진통조,재동기조건상사미행진통적356례산부위대조조.채용시각모의평분(VAS)평고궁축시동통,개량Bromage평분평고하지운동조체,기록진통효과、산정시간、분면방식、산후출혈、태인군박화신생인Apgar평분정황.결과 진통조교대조조재진통후30 min、궁구개전、태인면출시동통명현완해,활약기축단,음도순산솔고,부궁산솔저(t=31.989、39.586、35.893、-12.382,x2=34.685、36.854,균P＜0.05)；량조제이산정、제삼산정시간화음도조산솔、축궁소사용솔、신생인질식발생솔차이균무통계학의의(균P＞0.05).결론 갑광산라고잡인복합소분태니경막외조체분면진통효과학절、안전,무운동신경조체,불영향산정급신생인,가강저부궁산솔.
Objective To observe the effect ropivacaine mesylate combined with sufentanil on walking epidural laboranalgesia.Methods 360 puerperae who accepted 0.12％ ropivacaine mesylate combined with sufentanil (0.5 μg/ml) epidural analgesia were analgesic group;at the same time and under the similar conditions,the 356 cases of puerprtae unused analgesic were control group.With visual analogue scale(VAS) assessing the uterine contraction pain and improved Bromage scale assessing lower limb movement block,recording the analgesic effect,every labor time,delivery mode,and the condition of postpartum hemorrhage,fetal distress and neonatal Apgar score in every group.Results Labor pain of pain group significant relief,the active period shorten and the vaginal eutocia percentage were higher than those in the control group; Labor time of the secend and the third stage,vaginal birth rate and oxytocin utilization rate had no differences between the two groups.Conclusion The effect of epidural block labor analgesia on 0.12％ ropivacaine mesylate combined with sufentanil is obvious and security.There is no motor nerve block and do not affect the stage of labor and neonatal.It still can reduce the rate of cesarean section and improve maternal satisfaction.