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1、腰-硬联合镇痛用于产科分娩临床观察［摘要］目的探讨和研究罗哌卡因复合芬太尼腰-硬联合镇痛在分娩中应用的效果及其安全性。方法将112例于2011年2月〜2012年2月期间入住本院，ASAI〜II级单胎头位足月即将分娩的初产妇，随机均匀分为观察组和对照组，每组56例。观察组患者分娩时实施镇痛，即给予罗哌卡因复合芬太尼腰-硬联合镇痛方法进行镇痛；对照组患者分娩时未采取任何镇痛措施。观察产妇的镇痛效果、产程进展、分娩方式、产后出血量及不良反应，并记录新生儿Apgar评分。结果观察组产妇镇痛效果明显，第一产程活跃期镇痛满意度显著高
2、于对照组(P<0.01),第二产程镇痛效果也明显好于对照组(P<0.05)；观察组第一产程的活跃期明显缩短(P<0.05)、第二产程、第三产程两组差异无统计学意义(P>0.05)；顺产率明显高于对照组、剖宫产率明显低于对照组(P<0.05),阴道助产率两组差异无统计学意义(P>0.05)；两组产妇产后出血量、新生儿lminApgar和5minApgar评分均差异无统计学意义(P>0.05)o结论罗哌卡因复合芬太尼腰-硬联合镇痛效果好，且能缩短产程，提高顺产率，并对妇婴影响小。［关键词］罗哌卡因；芬太尼；腰-硬联合；分娩镇
3、痛［中图分类号］R614［文献标识码］B［文章编号］1674-4721(2012)07(b)-0105-03Clinicalobservationofspinal-epiduralanalgesiaforobstetricdeliveryLIAORongzhenCAOZihuaLIUShanfaMAZhiminWENRixinZHANGLixingDepartmentofAnesthesiology,Chang'anHospitalinDongguanCityofGuangdongProvince,Dongguan523
4、843,China[Abstract]ObjectiveToexploreandstudyofropivacainecombinedwithfentanylspinal-epiduralanalgesiceffectandsafetyinthedeliveryofapplications.MethodsOnehundredandtwelvecasesadmittedtoourhospitalfromFebruary2011toFebruary2012,ASAItoIIlevelsinglecephalictermabou
5、ttogivebirthearlymaternal,randomlyevenlydividedintoobservationgroupandcontrolgroup,eachgroupof56cases.Theobservationgrouppatientsimplementa/tionofanalgesiaduringchildbirth,givenropivacainecombinedwithfentanylspinal-epiduralanalgesiaanalgesia；Thecontrolgroupwereno
6、ttakenanyanalgesicduringchildbirth.Thematernalanalgesiceffect,theprogressoflabor,modeofdelivery,postpartumhemorrhage,andadversereactions,andrecordtheApgarscorewereobserved.ResuItsTheapparentanalgesicwaseffectinobservationgroup,theactiveperiodofthefirststageoflabo
7、ranalgesiasatisfactionwassignificantlyhigherthanthecontrolgroup(P0.05)；alongtheyieldwassignificantlyhighercesareansectionratewassignificantlylowerthanthecontrolgroup(P0.05)；Twosetsofma/ternalpostpartumhemorrhage,thenewborn1minApgarand5minApgarscore,therewasnosign
8、ificantdifference(P>0.05).ConclusionRopivacainecompoundfentanylwaist—epiduralanalgesiceffectisgoodanditcanshortentheproductionprocess,improvetheyieldofcis,andt
