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目的探讨导乐(助产士全程陪伴)联合硬膜外镇痛(EA)分娩对产程及分娩方式的影响。方法选择临产妇243例(镇痛组)实施导乐联合EA分娩,同期常规阴道分娩临产妇262例为对照组。镇痛组硬膜外镇痛用药为0.075%罗哌卡因与0.5μg/ml舒芬太尼混合液。比较两组产痛、产程时间、缩宫素应用、分娩方式和新生儿Apgar评分。结果镇痛组镇痛效果满意,第一、三产程VAS评分均<1分,第二产程VAS评分为(3.2±0.6)分。镇痛组第一产程活跃期时间明显短于对照组[(135.1±57.9)min vs.(189.9±71.5)min](P<0.05)。与对照组比较,镇痛组阴道分娩率高,剖宫产率低,但缩宫素使用率高(P<0.05或P<0.01)。两组产后出血量和新生儿Apgar评分相仿(P>0.05)。结论导乐联合EA分娩可有效减轻产妇分娩疼痛,提高阴道分娩成功率,对母婴无明显不良影响。
Objective To explore the effect of Dileh (midwife accompany) combined with epidural analgesia (EA) on labor process and delivery mode. Methods Seventy-two pregnant women (analgesic group) were enrolled in this study. The lead and EA combined with childbirth were enrolled in this study. 262 pregnant women undergoing vaginal delivery during the same period were selected as the control group. Analgesic group of epidural analgesic drug was 0.075% ropivacaine and 0.5μg / ml sufentanil mixture. Labor pain, labor duration, oxytocin use, mode of delivery and neonatal Apgar scores were compared between the two groups. Results The analgesic effect was satisfactory in the analgesic group. The VAS scores in the first and third trimester were both <1 and VAS in the second trimester was 3.2 ± 0.6. The active phase of the first stage of labor in the analgesic group was significantly shorter than that in the control group [(135.1 ± 57.9) min vs. (189.9 ± 71.5) min] (P <0.05). Compared with the control group, analgesia group vaginal delivery rate, cesarean section rate was low, but the oxytocin use rate was high (P <0.05 or P <0.01). The postpartum hemorrhage volume in both groups was similar to that of neonatal Apgar scores (P> 0.05). Conclusion Dianle combined with EA delivery can effectively reduce the pain of childbirth and improve the success rate of vaginal delivery, the mother and child had no significant adverse effects.