广州医科大学学报

目的 :探讨硬外麻醉的产科镇痛对产痛、产程、分娩方式、新生儿和产后出血的影响。方法 :选择 80例头位 ,无产科、麻醉禁忌证的自愿接受镇痛的初产妇 (观察组 ) ,在宫口开大 2～ 3cm时 ,给予硬外麻醉 ,并与同期条件相似 ,未给予任何镇痛方法的 80例初产妇进行对照 (对照组 ) ,比较两组产痛、产程时间、分娩方式、产后出血及对胎儿的影响。结果 :观察组镇痛有效率与对照组相比 ,统计学有极显著意义 (P <0 .0 1)。观察组活跃期较对照组缩短 ,但阴道助产率及剖宫产率却增高 ,分娩镇痛减少会阴侧剪伤口水肿 ,利于愈合。新生儿窒息及产后出血发生率比较 ,差异均无显著性 (P >0 .0 5 )。结论 :硬外麻醉镇痛可达到分娩镇痛 ,加速产程 ,利于宫口扩张 ,对新生儿无不良影响 ,在进一步改进方法 ,减少手术产率的基础上可推广应用。

Objective: To investigate the effects of epidural analgesia on labor pain, labor process, delivery mode, newborns and postpartum hemorrhage. Methods: 80 cases who were free of any obstetric complications and anesthesia contraindication were selected for the study group. Epidural anesthesia was applied when cervix dilated for about 2 3 cm. Another 80 pregnant women with similar obstetric condition were selected as control group and no analgesia was applied. The labor pain, duration, delivery mode, postpartum hemorrhage and the fetal status of the two groups were compared. Result: In the study group,epidural anesthesia showed good effect on relieving labor pain and shortening the active stage of labor course. There was no difference in the incidence of neonatal asphyxia and postpartum hemorrhage between the two groups. Conclusion: Epidural anesthesia is useful in relieving labor pain, accelerating labor course and produce no side effect on fetus.