罗哌卡因和芬太尼无痛分娩对产程及母婴的影响分析

20192019年2月第9卷第4期

·妇产医学·

罗哌卡因和芬太尼无痛分娩对产程及母婴的影响分析

梁兰芳

深圳市龙岗区妇幼保健院，广东深圳 518172

[摘要] 目的 对产妇行罗哌卡因+芬太尼硬膜外阻滞，观察母婴结局以及产妇产程。 方法 选择我院于2018

年2～8月期间收治的初产妇82例，采用随机数字表法将所有产妇分为观察组与对照组，各41例。对照

组产妇不接受分娩镇痛措施，观察组患者接受罗哌卡因+芬太尼硬膜外阻滞镇痛，比较两组产妇的产程以

及母婴结局。 结果 观察组产妇的第一产程、剖宫产率及胎儿窘迫率均明显低对照组产妇，即数据对比

差异有统计学意义（P＜0.05）；观察组产妇的第二产程、第三产程、产后出血量、新生儿的Apgar评分

与对照组患者比较差异无统计学意义（P＞0.05）。 结论产妇分娩期间，对产妇行罗哌卡因+芬太尼

硬膜外阻滞镇痛，不仅可以缩短产妇的第一产程，减少产妇剖宫产率，还能减少胎儿窘迫概率，值得临床

推广使用。

[关键词] 罗哌卡因；芬太尼；硬膜外阻滞镇痛；母婴结局

[中图分类号] R714.3 [文献标识码] A [文章编号] 2095-0616（2019）04-100-03

Effects of ropivacaine and fentanyl on labor process and mother-

infant

LIANG Lanfang

Longgang Maternal and Child Health Hospital,Shenzhen 518172,China

[Abstract] Objective To observe the maternal and infant outcomes of ropivacaine and fentanyl epidural block and the parturient labor process. Methods Eighty-two cases of primipara admitted to our hospital from February 2018 to August 2018 were selected and divided into the observation group and the control group taking the random number table as reference,with 41 cases in each group.The control group received no labor analgesia measures,while the observation group received ropivacaine and fentanyl epidural block analgesia.

The labor process and maternal and infant outcomes were compared between the two groups. Results The first stage of labor was observed,and the rate of cesarean section and fetal distress in the observation group were significantly lower than that in the control group,the difference was statistically significant (P＜0.05).There was no significant difference between the observation group and the control group in the second and third stages of labor,postpartum blood loss,and neonatal Apgar score (P＞0.05).Conclusion During parturient delivery,the parturient is treated with ropivacaine and fentanyl epidural block analgesia can not only shorten the parturient's first labor process,reduce the rate of cesarean section,but also reduce the probability of fetal distress,which is worthy of clinical promotion.

[Key words] Ropivacaine;Fentanyl;Epidural block anesthesia;Maternal and infant outcomes

产妇自然分娩过程中，普遍会存在一定的疼痛感，尤其初产妇，受焦虑、紧张等情绪的影响，分娩疼痛更为不耐受，此时，产妇体内儿茶酚胺分泌量会大幅度上升，影响母婴结局[1]。国外临床研究表明，在初产妇分娩期间，对产妇行无痛分娩，可以有效缩短产妇产程，优化母婴结局[2]。现阶段，无痛分娩主要包括椎管内阻滞镇痛、全身药物镇痛、经皮电刺激以及心理干预等方案，由于产妇存在一定的个体差异，加之医疗机构客观条件的影响，无痛分娩方式存在较大的不同，但随着麻醉技术的不断完善，椎管内阻滞镇痛技术广泛受到青睐[3-4]。本次选择我院于2018年2～8月期间收治的初产妇82例，就常规分娩以及罗哌卡因+芬太尼硬膜外阻滞镇痛在产程、母婴结局方面的影响进行如下对照分析。

1 资料与方法

1.1 一般资料

选择我院于2018年2～8月期间收治的初产妇82例，纳入标准：单胎头位；产前胎心监护指标异常；不存在头盆相称或是脐带绕颈等情况；产妇自行签署研究知情同意书。排除标准：妊娠期高血压产妇；心脏病产妇；糖尿病产妇；精神疾病产妇；

100CHINA MEDICINE AND PHARMACY Vol.9 No.4 February