罗哌卡因和芬太尼无痛分娩对产程及母婴的影响分析
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摘要
目的对产妇行罗哌卡因+芬太尼硬膜外阻滞,观察母婴结局以及产妇产程。方法选择我院于2018年2～8月期间收治的初产妇82例,采用随机数字表法将所有产妇分为观察组与对照组,各41例。对照组产妇不接受分娩镇痛措施,观察组患者接受罗哌卡因+芬太尼硬膜外阻滞镇痛,比较两组产妇的产程以及母婴结局。结果观察组产妇的第一产程、剖宫产率及胎儿窘迫率均明显低对照组产妇,即数据对比差异有统计学意义(P <0.05);观察组产妇的第二产程、第三产程、产后出血量、新生儿的Apgar评分与对照组患者比较差异无统计学意义(P> 0.05)。结论产妇分娩期间,对产妇行罗哌卡因+芬太尼硬膜外阻滞镇痛,不仅可以缩短产妇的第一产程,减少产妇剖宫产率,还能减少胎儿窘迫概率,值得临床推广使用。
Objective To observe the maternal and infant outcomes of ropivacaine and fentanyl epidural block and the parturient labor process. Methods Eighty-two cases of primipara admitted to our hospital from February 2018 to August 2018 were selected and divided into the observation group and the control group taking the random number table as reference,with 41 cases in each group.The control group received no labor analgesia measures,while the observation group received ropivacaine and fentanyl epidural block analgesia.The labor process and maternal and infant outcomes were compared between the two groups. Results The first stage of labor was observed,and the rate of cesarean section and fetal distress in the observation group were significantly lower than that in the control group,the difference was statistically significant(P < 0.05).There was no significant difference between the observation group and the control group in the second and third stages of labor,postpartum blood loss,and neonatal Apgar score(P > 0.05). Conclusion During parturient delivery,the parturient is treated with ropivacaine and fentanyl epidural block analgesia can not only shorten the parturient's first labor process,reduce the rate of cesarean section,but also reduce the probability of fetal distress,which is worthy of clinical promotion.
Objective To observe the maternal and infant outcomes of ropivacaine and fentanyl epidural block and the parturient labor process. Methods Eighty-two cases of primipara admitted to our hospital from February 2018 to August 2018 were selected and divided into the observation group and the control group taking the random number table as reference,with 41 cases in each group.The control group received no labor analgesia measures,while the observation group received ropivacaine and fentanyl epidural block analgesia.The labor process and maternal and infant outcomes were compared between the two groups. Results The first stage of labor was observed,and the rate of cesarean section and fetal distress in the observation group were significantly lower than that in the control group,the difference was statistically significant(P < 0.05).There was no significant difference between the observation group and the control group in the second and third stages of labor,postpartum blood loss,and neonatal Apgar score(P > 0.05). Conclusion During parturient delivery,the parturient is treated with ropivacaine and fentanyl epidural block analgesia can not only shorten the parturient's first labor process,reduce the rate of cesarean section,but also reduce the probability of fetal distress,which is worthy of clinical promotion.
引文
[1]李晓红,王克涛,李娅,等.0.1%罗哌卡因复合舒芬太尼用于无痛分娩的效果[J].中国医药导报,2016,13(27):131-134.
[2]张弛.罗哌卡因复合舒芬太尼硬膜外阻滞在分娩镇痛中的应用[J].山西医药杂志,2016,45(13):1569-1570.
[3]赵影,张春雨.罗哌卡因联合舒芬太尼用于无痛分娩及对胎心监护、血气分析的影响研究[J].检验医学与临床,2017,14(19):2949-2951.
[4]樊薇,杨琳,史玉琴.罗哌卡因、舒芬太尼联合穴位针刺在无痛分娩中的应用效果[J].西部中医药,2018,31(1):98-101.
[5]季小清.不同浓度罗哌卡因复合芬太尼用于分娩镇痛效果及母婴结局比较[J].现代仪器与医疗,2017,23(3):54-56.
[6]李铁军,蔡淑女,印春铭.舒芬太尼联合不同浓度罗哌卡因行阶梯式分娩镇痛对产程进展和新生儿的影响研究[J].中国妇幼保健,2016,31(1):185-187.
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[9]王汉和,蒋旻珈,廖万东.舒芬太尼联合不同浓度罗哌卡因分娩镇痛对母体影响的研究[J].海南医学院学报,2016,22(23):2921-2924.
[10]李冰,陈绪军,郭艳,等.不同浓度罗哌卡因复合舒芬太尼在硬膜外阶梯式分娩镇痛中的应用[J].临床麻醉学杂志,2016,32(4):361-365.
[11]陈健,陈清娟,郑丹,等.罗哌卡因复合舒芬太尼用于产妇自控硬膜外分娩镇痛的效果及对血浆催乳素的影响[J].中国性科学,2017,26(2):102-104.
[12]张弛,王治,卫建峰,等.罗哌卡因联合舒芬太尼和罗哌卡因联合芬太尼在硬膜外分娩镇痛中的应用及对比研究[J].中国药物与临床,2017,17(3):430-432.
[13]李友炯.罗哌卡因复合舒芬太尼用于初产妇无痛分娩的临床效果观察[J].中国妇幼保健,2017,32(23):6032-6034.
[14]徐进辉,沈海涛,孙文杰,等.硬膜外罗哌卡因复合右美托咪定用于分娩镇痛时对母婴的影响[J].广东医学,2017,38(17):2699-2702.
[15]刘国华,韦天全.舒芬太尼复合不同剂量罗哌卡因蛛网膜下腔阻滞在产程潜伏期分娩镇痛中的应用[J].中国妇幼保健,2016,31(10):2068-2070.
[2]张弛.罗哌卡因复合舒芬太尼硬膜外阻滞在分娩镇痛中的应用[J].山西医药杂志,2016,45(13):1569-1570.
[3]赵影,张春雨.罗哌卡因联合舒芬太尼用于无痛分娩及对胎心监护、血气分析的影响研究[J].检验医学与临床,2017,14(19):2949-2951.
[4]樊薇,杨琳,史玉琴.罗哌卡因、舒芬太尼联合穴位针刺在无痛分娩中的应用效果[J].西部中医药,2018,31(1):98-101.
[5]季小清.不同浓度罗哌卡因复合芬太尼用于分娩镇痛效果及母婴结局比较[J].现代仪器与医疗,2017,23(3):54-56.
[6]李铁军,蔡淑女,印春铭.舒芬太尼联合不同浓度罗哌卡因行阶梯式分娩镇痛对产程进展和新生儿的影响研究[J].中国妇幼保健,2016,31(1):185-187.
[7]朱群芳.舒芬太尼配伍罗哌卡因椎管内麻醉用于无痛分娩的临床效果观察[J].中国妇幼保健,2017,32(22):5559-5562.
[8]卢园园,刘绪华,杨芳骅,等.罗哌卡因复合芬太尼硬膜外用药对分娩方式的影响[J].浙江医学,2016,38(1):32-35.
[9]王汉和,蒋旻珈,廖万东.舒芬太尼联合不同浓度罗哌卡因分娩镇痛对母体影响的研究[J].海南医学院学报,2016,22(23):2921-2924.
[10]李冰,陈绪军,郭艳,等.不同浓度罗哌卡因复合舒芬太尼在硬膜外阶梯式分娩镇痛中的应用[J].临床麻醉学杂志,2016,32(4):361-365.
[11]陈健,陈清娟,郑丹,等.罗哌卡因复合舒芬太尼用于产妇自控硬膜外分娩镇痛的效果及对血浆催乳素的影响[J].中国性科学,2017,26(2):102-104.
[12]张弛,王治,卫建峰,等.罗哌卡因联合舒芬太尼和罗哌卡因联合芬太尼在硬膜外分娩镇痛中的应用及对比研究[J].中国药物与临床,2017,17(3):430-432.
[13]李友炯.罗哌卡因复合舒芬太尼用于初产妇无痛分娩的临床效果观察[J].中国妇幼保健,2017,32(23):6032-6034.
[14]徐进辉,沈海涛,孙文杰,等.硬膜外罗哌卡因复合右美托咪定用于分娩镇痛时对母婴的影响[J].广东医学,2017,38(17):2699-2702.
[15]刘国华,韦天全.舒芬太尼复合不同剂量罗哌卡因蛛网膜下腔阻滞在产程潜伏期分娩镇痛中的应用[J].中国妇幼保健,2016,31(10):2068-2070.