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时间:2020-04-02
《持续硬膜外阻滞麻醉镇痛分娩对胎儿和新生儿的影响费.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、齐鲁护理杂志2012年第18卷第26期持续硬膜外阻滞麻醉镇痛分娩对胎儿和新生儿的影响12*叶宁,许勤(1.南京医科大学附属南京妇幼保健院江苏南京210004;2.南京医科大学护理学院外科护理学教研室)【摘要】目的:探讨持续硬膜外阻滞麻醉镇痛分娩对胎儿和新生儿的影响。方法:根据产妇对采用持续硬膜外阻滞麻醉镇痛分娩的意愿分为观察组230例和对照组210例,对照组自愿选择通过拉美兹呼吸法、按摩等方式减轻分娩疼痛;观察组自愿选择在宫口开大2cm时采取持续硬膜外阻滞麻醉镇痛分娩。结果:观察组产程中胎心率变异振幅比对照组小(P<0.01);观察组宫口开全时胎方位枕
2、前位比例低于对照组(P<0.01);两组新生儿出生后1min时Apgar评分比较差异无统计学意义;对照组新生儿出生后30min、60min时吸吮反射评分高于观察组(P<0.01,P<0.05),而出生120min时两组吸吮反射评分比较差异无统计学意义。结论:镇痛分娩减轻了产妇疼痛程度,使胎儿供氧增多,胎心平稳。但镇痛分娩影响了胎方位的旋转,使胎儿受挤压时间较长,影响了新生儿吸吮反射评分,随着新生儿出生后时间的延长,吸吮反射评分逐渐正常。【关键词】硬膜外阻滞麻醉;分娩;镇痛;胎儿;新生中图分类号:R473.71文献标识码:ADOI:10.3969/j.i
3、ssn.1006-7256.2012.26.003文章编号:1006-7256(2012)26-0004-02ImpactofdeliveryanalgesiaundercontinuousepiduralblockanesthesiaonfetusesandneonatesYeNing,XuQin(NanjingMaternalandChildHealthCareHospitalAffiliatedtoNanjingMedicalUniversity,NanjingJiangsu210004,P.R.China)【Abstract】Objective
4、:Tostudytheimpactofdeliveryanalgesiaundercontinuousepiduralblockanesthesiaonfetusesandneonates.Methods:Thoseparturientweredividedintoanobservationgroup(n=230)andacontrolgroup(n=210)accordingtotheirdesireofac-ceptingdeliveryanalgesiaundercontinuousepiduralblockanesthesia.Thepartu
5、rientinthecontrolgroupselectedLamazebreathingtech-niquesandmassageforanalgesiaduringdelivery;theparturientintheobservationgroupacceptedcontinuousepiduralblockanesthesiaforanalgesiaduringlaborwhenorificeoftheuterusopenedat2cm.Results:Thevariationamplitudeoffetalheartratewaslessin
6、theobserva-tiongroupthanthecontrolgroup(P<0.01);theratioofoccipito-anteriorpositionwaslowerwhenorificeoftheuterusfullyopenedinobservationgroupthanthecontrolgroup(P<0.01);therewasnostatisticallysignificantdifferenceinthecomparisonofApgarscoreafterchildbirthforoneminutebetweenthet
7、wogroups;thesuckingreflexscoreafterbirthfor30and60minuteswashigherinthecontrolgroupthantheobservationgroup(P<0.01,P<0.05);thecomparisonofthesuckingreflexscoreafterbirthfor120minuteswasnotsignificant-lydifferentbetweenthetwogroups.Conclusion:Thedeliveryanalgesiacanreducethedegree
8、ofpainindeliveryandsupplymuchoxygenforthefetusa
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