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目的探究腰硬联合麻醉与自控硬膜外镇痛用于镇痛方案的可行性及安全性。方法 450例分娩的初产妇,采用前瞻性、队列对照研究方法将产妇分为研究组和对照组,每组225例。两组均进行产程常规管理,在此基础上研究组行腰硬联合麻醉与自控硬膜外镇痛,对照组未行分娩镇痛。观察并比较两组产妇的视觉模拟评分法(VAS)评分、新生儿出生情况、不良反应发生情况等指标。结果镇痛后,研究组产妇VAS评分明显低于对照组(P<0.05);两组产后2 h内阴道出血量、产后出血率、新生儿Apgar评分比较差异均无统计学意义(P>0.05);研究组不良反应发生率为5.8%,与对照组的6.2%比较差异无统计学意义(P>0.05)。结论腰硬联合麻醉与自控硬膜外镇痛用于临床分娩镇痛,具有见效快、镇痛效果好等优点,能够快速有效的减轻产妇分娩过程中的痛苦,可以在临床上推广应用。
Objective To explore the feasibility and safety of combined spinal and epidural anesthesia with controlled epidural analgesia for analgesia. Methods A total of 450 primiparous women who gave birth were divided into study group and control group with 225 cases in each group by prospective, cohort and comparative study. Both groups were routine management of labor, on this basis, the study group combined spinal and epidural anesthesia with self-controlled epidural analgesia, the control group did not labor analgesia. Visual analog scale (VAS) score, neonatal birth, adverse reactions and other indicators were observed and compared between the two groups. Results After the analgesia, the VAS score of the study group was significantly lower than that of the control group (P <0.05). There was no significant difference in vaginal bleeding volume, postpartum hemorrhage rate and neonatal Apgar score between the two groups (P> 0.05 ). The incidence of adverse reactions in the study group was 5.8%, which was not significantly different from that in the control group (6.2%) (P> 0.05). Conclusion Combined spinal and epidural anesthesia and controlled epidural analgesia are effective in clinical labor analgesia. They have the advantages of quick response and good analgesic effect. They can quickly and effectively relieve the pain of childbirth and can be widely applied in clinic.