论文部分内容阅读
目的:探讨宫颈局部麻醉和硬膜外分娩镇痛对初产妇产程及分娩结局的影响。方法:选取我院2012年7月-2013年6月住院分娩初产妇166例,年龄20-27岁,无妊娠合并症和并发症,孕37-41+6周(259-293天),阴道分娩均行会阴侧切术。随机分成三组:组1为49例,产程中宫口开1-2cm予盐酸利多卡因纱布浸湿均匀覆盖宫口;组2为46例,宫口开2-3cm予硬膜外阻滞麻醉;组3为对照组71例,产程中未予干预。比较三组第1、2、3产程时间、产后2小时出血量、新生儿评分等指标。结果:1宫颈局部麻醉组第一产程明显短于分娩镇痛及对照组,差异有统计学意义(P<0.05);2分娩镇痛组产后出血量明显多于宫颈局麻组和对照组,差异有统计学意义(P<0.05)。3新生儿评分三组差异无统计学意义。结论:宫颈局部麻醉在正常阴道分娩中能缩短产程;分娩镇痛能改善宫缩时疼痛,但对缩短产程意义不大,其产后出血量明显增加,需要在胎儿娩出后尽早静脉滴注缩宫素,防止宫缩乏力导致产后大出血。
Objective: To investigate the effect of local anesthesia and epidural analgesia on labor and delivery outcomes of primipara. Methods: 166 cases of primipara in our hospital from July 2012 to June 2013 were selected, aged 20-27 years old, without pregnancy complications and complications, 37-41 + 6 weeks (259-293 days), vagina Delivery are episiotomy. Randomly divided into three groups: Group 1 was 49 cases of labor in the cervix to open 1-2cm lidocaine hydrochloride gauze soaking evenly covered uterine cervix; Group 2 46 cases, cervix open 2-3cm to epidural block Anesthesia; group 3 as the control group, 71 cases, no interruption of labor. Three groups of 1,2,3 labor time, 2 hours postpartum hemorrhage, neonatal score and other indicators. Results: (1) The first stage of labor in cervical local anesthesia group was significantly shorter than that of labor analgesia and control group, the difference was statistically significant (P <0.05); 2 postpartum hemorrhage in labor analgesia group was significantly more than that in cervical local anesthesia group and control group, The difference was statistically significant (P <0.05). 3 neonatal score was no significant difference between the three groups. Conclusion: Cervical local anesthesia can shorten the labor process in normal vaginal delivery. Labor analgesia can improve the pain of uterine contraction, but has little significance in shortening the labor process. The postpartum hemorrhage volume increases obviously. It is necessary to intravenously instil the ectasia Su, prevent uterine inertia leading to postpartum hemorrhage.