【摘要】 目的探讨联合应用腰麻及硬膜外麻醉（ＣＳＥＡ）减轻或消除产痛以及对产程、胎儿、分娩方式的影响。方法选择８０例无产科、麻醉禁忌证的初产妇（观察组），在宫口开大２～３ｃｍ时，给予联合腰麻及硬膜外麻醉，并与同期条件相似、未给予任何镇痛方法的８０例初产妇进行对照（对照组）。比较两组产痛程度、产程进展速度、分娩方式及对胎儿的影响。结果观察组镇痛有效率较对照组明显升高（Ｐ＜０．０１）。观察组活跃期较对照组缩短，宫颈扩张速度加快、剖宫产率下降，经阴道助产分娩率增高（Ｐ＜０．０５）。胎儿窘迫及新生儿窒息、产后出血发生率两组比较，差异均无显著性（Ｐ＞０．０５）。结论ＣＳＥＡ应用于产科，可达到分娩镇痛、加速产程、降低剖宫产率的作用，且对胎儿无不良影响，值得推广应用更多还原

【Abstract】 Objective To investigate the effect of combined spinal and epidural anesthesia (CSEA) on relieving and eliminating labor pain and the effect on newborns, labor process and delivery mode. Methods 80 cases without any obstetric complications and anesthetic contraindications were selected for the study group. CSEA was applied when cervix dilated for about 2～3 cm, 80 pregnant women with similar obstetric condition as control group without any anesthesia. We compared the labor pain, duration, delivery mode and fetal status of two groups. Results In study group CSEA showed good effect on relief of labor pain, shortening the active phase of labor course and acceleration of cervical dilation. There are no different in the incidence of fetal distress, neonatal asphyxia and postpartum hemorrhage between two groups. Conclusion Apllication of CSEA is useful in relieving labor pain, accelerating labor course, lowering cesarean section rate without any side effect on fetus.更多还原