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

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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