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河北医学  2018, Vol. 24 Issue (12): 2086-2089    DOI: 10.3969/j.issn.1006-6233.2018.12.038
  临床研究 本期目录 | 过刊浏览 | 高级检索 |
腰麻差异量盐酸罗哌卡因分娩镇痛与导乐仪镇痛的临床对比研究
宋阳,高扬,张祎明,郭东侠,张力方,苏凤龙,孙鹏
河北省承德市妇幼保健院麻醉科, 河北 承德 067000
Study on the Clinical Comparation of Different Dosage of Ropivacaine Hydrochloride for Labor Analgesia and Doula Analgesia
SONG Yang, GAO Yang, ZHANG Yiming, et al
Chengde Maternal and Child Health-Care Hospital, Hebei Chengde 067000, China
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摘要  目的: 比较分析腰麻差异量盐酸罗哌卡因分娩镇痛与导乐仪镇痛的效果。方法: 将2017年3月至2018年12月要求行神经和肌肉刺激仪分娩镇痛的200名初产妇作为对照组(A组),要求行腰硬联合麻醉分娩镇痛的400名初产妇,根据产妇入院顺序随机抽号均分为B1组和B2组,各200名。观察并记录三组的镇痛效果、产程时间、宫缩变化、产后出血量、新生儿Apger评分、运动时间阻滞程度。结果: 在年龄、身高、体重、孕周以及手术耗时方面,研究组和对照组无显著差异(P>0.05);三组镇痛效果比较显示,B1组和B2组有效镇痛显著高于A组(P<0.05),而0级镇痛效果方面,B2组显著高于A组和B1组,(P<0.05);三组产妇活跃期方面比较显示,B1、B2组活跃期时间和第二产程时间显著长于A组(P<0.05),B1组活跃期显著短于B2组(P<0.05);三组产妇宫缩情况比较无差异(P>0.05);B1组和B2组产后出血量显著大于A组(P<0.05),B1组产后出血量显著少于B2组(P<0.05);三组新生儿Apger评分比较无差异(P>0.05);三组产妇运动阻滞程度比较显示,A组无阻滞运动例数显著高于B1、B2组(P<0.05)。结论: 腰麻注射盐酸罗哌卡因分娩镇痛的镇痛效果优于导乐仪镇痛,其中B1组腰麻方案与B2组相比,产程短,对产妇宫缩影响小,分娩镇痛效果最佳。
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关键词 腰硬联合麻醉盐酸罗哌卡因分娩镇痛导乐仪    
AbstractObjective: To compare and analyze the difference between lumbar spinal anesthesia and ropivacaine hydrochloride for labor analgesia and Doula analgesia. Methods: From March 2017 to December 2018, 200 primiparas who were required to perform labor analgesia with nerve and muscle stimulator in our hospital were used as control group (group A) and 400 primiparae who were required to undergo combined spinal-epidural anesthesia for labor analgesia. According to the order of admission of puerpera, they were randomly divided into B1 group and B2 group, 200 patients in each group. The analgesic effect, labor duration, uterine contraction, postpartum hemorrhage, neonatal Apger score and the degree of motor block were observed and recorded. Results: There was no significant difference in age, height, weight, gestational age and operation time between the study group and the control group (P>0.05). The analgesic effect of group B1 and B 2 was significantly higher than that of group A (P<0. 05), but the analgesic effect of group 0 was significantly higher than that of group A and group B1 (, (P<0. 05). The time of active period and the second stage of labor in group B1 and B2 were significantly longer than those in group A (P<0.05) and the active period in group B1 was significantly shorter than that in group B2 (P<0.05), but there was no significant difference among the three groups (P> 0.0). 5) the amount of postpartum hemorrhage in group B 1 and group B2 was significantly higher than that in group A (P<0 05), and the amount of postpartum hemorrhage in group B1 was significantly lower than that in group B 2 (P<0 05), and there was no difference in Apger scores among the three groups (P> 0 05). The degree of motor block in group A was significantly higher than that in group B1 (P<0.05). Conclusion: The analgesic effect of injection of ropivacaine hydrochloride by injection of lumbar anesthesia is better than the analgesic effect of the guide instrument. In group B1, the regimen of lumbar anesthesia is shorter than that in the B2 group, and the effect on the uterine contraction is small, and the effect of labor analgesia is the best.
Key wordsCombined spinal and hard anesthesia    Ropivacaine    Labor analgesia    Doula instrument
    
基金资助:河北省承德市科技计划项目,(编号:201706A007)
引用本文:   
宋阳,高扬,张祎明,郭东侠,张力方,苏凤龙,孙鹏. 腰麻差异量盐酸罗哌卡因分娩镇痛与导乐仪镇痛的临床对比研究[J]. 河北医学, 2018, 24(12): 2086-2089.
SONG Yang, GAO Yang, ZHANG Yiming, et al. Study on the Clinical Comparation of Different Dosage of Ropivacaine Hydrochloride for Labor Analgesia and Doula Analgesia. HeBei Med, 2018, 24(12): 2086-2089.
链接本文:  
http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.038     或     http://www.hbyxzzs.cn/CN/Y2018/V24/I12/2086
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