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PCEA用于分娩镇痛对母婴的影响
作者:于红 蒋小青 燕筠 
单位:东南大学附属中大医院妇产科,
关键词:硬膜外病人自控镇痛 分娩 疗效观察 
分类号:R714.3
出版年·卷·期(页码):2001·20·第一期(52-54)
摘要:

目的:观察硬膜外病人自控镇痛(patient controlled epidural analgesia,PCEA)用于分娩镇痛的效果及对产程和母婴的影响。方法:选择无合并症孕妇100例,随机分为无痛组和对照组各50例。无痛组是在宫口扩张潜伏期末或活跃期自愿要求无痛分娩的产妇,取L3~4间隙为穿刺点,首次用0.75%利多卡因5ml,连接PCA泵,内置溶液60ml(0.125%布比卡因加芬太尼1~2mg*L-1),第1小时<15ml,以后约10ml*h-1,用药量4~55ml,至宫口近全或开全时停药,观察镇痛效果、产程、分娩方式、产后出血量及胎儿新生儿情况。结果:无痛组虽然子宫收缩有短时间的轻度抑制,但不影响产力,活跃期缩短,第二产程不用药可避免该产程延长。羊水污染、胎心异常及新生儿评分与对照组比无显著差异。结论:PCEA用于分娩镇痛安全、有效,对母婴均无不良影响。

Objective  To investigate the pain relief effects of patient controlled epidural analgesia(PCEA) and its influences on both mothers and infants.Methods  50 pregnant women were administered PCEA (study group)50 pregnant women were not administered any labor analgesia (control group).The labor course,the mode of delivery and incidence of postpartum hemorrhage,fetal distress and neonatal asphyxia were observed in the two groups respectively.Results  PCEA had a little influence on uterus contraction in short time,but no influence on delivery.It could also accelerate the progress of the active phase.It could stop the prolongation of the second stage of labor if drugs were not used during this time.Conclusion  PCEA is effective and safe to labor analgesia,it is also safe to both mothers and infants.

参考文献:

[1] 罗爱伦. 病人自控镇痛, 1999
[2] 张秉钧. 椎管内注药作分娩镇痛近况, 1996(2)
[3] Macarthur A, Macarthur C, Weeks S. Epidural anaesthesia and low back pain after delivery:a prospective cohort study, 1995
[4] 王德智. 硬膜外阻滞无痛分娩, 1992(6) 

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