罗哌卡因复合芬太尼用于分娩镇痛的临床效果观察

　　【摘要】 目的 探讨罗哌卡因复合芬太尼自控镇痛用于分娩镇痛的效果及对分娩的影响。 方法 采用回顾性分析的方法，选择200例健康、单胎、足月临产初产妇，随机分为两组：观察组(100例)，对照组(100例)，采用0.1%罗哌卡因+芬太尼(1μg/ml)硬膜外腔给药用于分娩镇痛，观察两组产妇的镇痛效果、产程时间、分娩方式、新生儿Αpgar评分、产后24小时出血量。 结果 (1)镇痛有效率为96.0%。(2)两组产妇在产程中血压(BP)、脉搏(P)、呼吸(R)的变化差异无显著性(P>0.05)。(3)产程时间比较：第一产程和总产程差异有显著性(P<0.01，P<0.05)，第二产程、第三产程差异无显著性(P>0.05)。(4)分娩方式及缩宫素使用情况比较：观察组缩宫素使用明显多于对照组，差异有显著性(P<0.05);经阴道自然分娩及阴道助产比较差异无显著性(P>0.05，P>0.05);剖宫产比较差异有显著性(P<0.05)。(5)新生儿Αpgar评分及产后24小时出血量两组比较，差异均无显著性(P>0.05，P>0.05)。结论 低浓度的罗哌卡因复合芬太尼用于分娩镇痛对产妇第一产程及总产程有缩短作用，降低剖宫产率，自控镇痛，同时增加了缩宫素使用率，但对新生儿出生结局无明显影响。

　　【关键词】 分娩镇痛;酰胺类;硬盘膜外腔;自控镇痛

　　Observing the clinical effect of epidural ropivacaine compounding fentanyl labor analgesia

　　ZHAO Jing-jing

　　Dept. of Obstetrics and Gynecology, Linyi People s Hospital, Linyi 276003, China

　　Abstract：Objective: To explore the effect of epidural ropivacaine compounding fentanyl labor analgesia and its influence on labor. Methods: With regressive analytic method , 200 healthy primiparas with single fetus and term labor was randomly devided intoobserved group (100 cases) and control group (100 cases). In observed group, pregnant women accepted patient-controlled epidural analgesia (PCEA) with 0.1% ropivacaine + fentanyl (1μg/ml) while in control group who accepted nothing. Effect of analgesia 、the duration of labor、modes of delivery、neonatal Apgar score and the volume of postpartum hemorrhage in 24 hours were recorded and evaluated. Results 1) The efficient rate of labor analgesia is 96.0%. 2) In the two groups, there is no significant difference in blood pressure、pulse and respiratory (P>0.05). 3) Compared the duration of labor of the two groups, there were significant difference in both first stage (P<0.01) and total stage (P<0.05) of labor while no significant difference in second stage and third stage (P>0.05). 4) In observed group, cases using oxytocin were more than that of control group(P<0.05);

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