CAJ | 학술논문

目的：观察自控腰硬与分娩镇痛联合麻醉下不同停泵时机对产程和分娩结局的影响。方法回顾性分析2012年7月至2013年7月辛集市第一医院收治的足月分娩、单胎头位的126例初产妇的临床资料，依据不同停泵时机分为宫口开全停泵组（A组）；宫口开全停泵，胎儿娩出后立即开泵组（B组）；第一、二、三产程持续镇痛组（ C组），每组42例。采用视觉模拟评分（ visual analogue scale， VAS）评价3组产妇产程中不同时间段的镇痛情况；观察并记录3组产妇第一、二、三产程的时间以及缩宫素使用情况；记录产后2h出血量、剖宫产情况；采用Apgar评分在新生儿出生的1 min、5 min、10 min各评定一次。结果3组与T0比较，T1～5均降低明显（ P＜0.05）；与C组比较，A、B两组的T4～5增加明显，第二产程中缩宫素使用率、剖宫产率均降低明显（ P＜0.05）。结论持续进行自控腰硬与分娩镇痛者可导致缩宫素使用率增加，导致剖宫产的概率增加，但产妇的疼痛程度较小。
목적：관찰자공요경여분면진통연합마취하불동정빙시궤대산정화분면결국적영향。방법회고성분석2012년7월지2013년7월신집시제일의원수치적족월분면、단태두위적126례초산부적림상자료，의거불동정빙시궤분위궁구개전정빙조（A조）；궁구개전정빙，태인면출후립즉개빙조（B조）；제일、이、삼산정지속진통조（ C조），매조42례。채용시각모의평분（ visual analogue scale， VAS）평개3조산부산정중불동시간단적진통정황；관찰병기록3조산부제일、이、삼산정적시간이급축궁소사용정황；기록산후2h출혈량、부궁산정황；채용Apgar평분재신생인출생적1 min、5 min、10 min각평정일차。결과3조여T0비교，T1～5균강저명현（ P＜0.05）；여C조비교，A、B량조적T4～5증가명현，제이산정중축궁소사용솔、부궁산솔균강저명현（ P＜0.05）。결론지속진행자공요경여분면진통자가도치축궁소사용솔증가，도치부궁산적개솔증가，단산부적동통정도교소。
Objective To observe the effect of different anesthesia pump stop time in self controlled lumbar epidural anesthesia combined with labor analgesia on birth process and delivery outcomes.Methods Data of 126 primiparas with hospital inspection and delivery, term single head position in The First Hospital of Xinji City from July 2012 to July 2013 were retrospectively analyzed. According to different pump stop time, the primiparas were divided into 3 groups: pump stop when cervical dilatation as group A. Pump stop when cervical dilatation and pump restart after fetus delivery as group B.Continuous analgesia in first second and third birth process as group C, with 42 cases in each group.Adopted visual analogue scale( VAS) to evaluate puerperants’ analgesia statuses in birth process different time of 3 groups, to observe and record puerperants’ first, second and third birth process time and oxytocin usage, blood loss amount after delivery 2 hours, cesarean section status of 3 groups.At the same time adopted Apgar evaluated neonates at 1th min, 5th min and 10th min after they birthed.Results Compared with T0, three group’s every indexes all obviously decreased from T1 to T5 (P<0.05);Compared with the third group, first and second group’s every indexes all obviously increased from T4 to T5, oxytocin unilization ratio in the second delivery process and oxytocin total unilization ratio, cesarean rate all obviously decreased ( P<0.05) .Conclusion Continuous carry out self controlled lumbar epidural anesthesia and labor anesthesia will lead to increase of oxytocin usage and cesarean section ratio, while relieve the pain degree of puerperants.