导乐仪和椎管内阻滞麻醉的临床效果观察

发布时间：2017-12-26 20:19

本文关键词：导乐仪和椎管内阻滞麻醉的临床效果观察　出处：《中国城乡企业卫生》2016年03期 　论文类型：期刊论文

【摘要】：目的探讨GT-4A导乐仪与椎管内麻醉两种镇痛方法对分娩镇痛的临床效果及对产妇和新生儿的影响。方法将160例产妇随机分为3组:A组(60例)使用GT-4A导乐仪进行镇痛,B组(50例)进行椎管内阻滞麻醉,C组(50例)为对照组。采用视觉模糊评分法(VAS)评定镇痛效果,观察3组的镇痛效果及其不良反应、产程、分娩方式、产后出血量、羊水污染情况以及新生儿Apgar评分。结果镇痛组(A组和B组)镇痛效果明显,镇痛后起效时VAS评分与镇痛前相比明显下降,镇痛组在宫口开大3cm、6cm及宫口开全时,与对照组(C组)相比,VAS评分显著下降,差异均有统计学意义(P0.01)。A、B两组第一产程时间与C组相比,均明显缩短,差异有统计学意义(P0.05)。A组和B组顺产率明显高于C组,A组剖宫产率低于B、C两组,差异均有统计学意义(P0.05)。产后出血、羊水污染情况及新生儿Apgar评分3组差异无统计意义(P0.05)。结论 GT-4A导乐仪和椎管内麻醉均可以明显减轻产妇的产痛,缩短第一产程,提高自然分娩率,GT-4A导乐仪还可以有效降低剖宫产率,有效避免麻醉镇痛药的不良反应,值得推广应用。
[Abstract]:Objective to investigate the clinical effects of two analgesia methods of anesthesia and intrathecal GT-4A instrument of Doula on labor analgesia and effects on maternal and neonatal. Methods 160 cases were randomly divided into 3 groups: A group (60 cases) analgesia using GT-4A doula instrument, B group (50 cases) of spinal anesthesia, group C as control group (50 cases). Visual analy tic score (VAS) was used to evaluate the analgesic effect. The analgesic effect and adverse reactions, duration of labor, delivery mode, postpartum hemorrhage, amniotic fluid contamination and neonatal Apgar score were observed in the 3 groups. Results analgesia group (group A and group B) had significant analgesic effect. The VAS score decreased significantly after onset of analgesia. Compared with that before analgesia, the pain score of the analgesia group was significantly lower than that of the control group (C group) when the opening of the uterus was 3cm, 6cm and the opening of the uterus, and the difference was statistically significant (P0.01). The first time of labor of A and B two groups was significantly shorter than that in group C, and the difference was statistically significant (P0.05). The rate of spontaneous delivery in group A and group B was significantly higher than that in group C. The rate of cesarean section in group A was lower than that of B and C two groups, the difference was statistically significant (P0.05). There was no statistical significance between the 3 groups of postpartum hemorrhage, amniotic fluid pollution and neonatal Apgar score (P0.05). Conclusion Doula GT-4A instrument and spinal anesthesia can significantly reduce maternal pain, shorten the first stage of labor, improve the rate of natural childbirth, GT-4A instrument doula can effectively reduce the rate of cesarean section, avoid the adverse reactions of narcotic analgesics, it is worthy of popularization and application.
【作者单位】：天津市红桥医院妇产科;
【分类号】：R714.3
【正文快照】： 分娩时的剧烈疼痛会对产妇和胎儿产生很多不良影响,因此,如何在保障母婴安全的前提下最大限度地降低产痛,是医生和产妇共同关心的问题。一直以来,在分娩镇痛中常采用椎管内阻滞麻醉的方法。其优点是镇痛效果显著,对母婴影响较小,缺点是延长产程,剖宫产率上升以及麻醉药物本身

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