【摘要】 目的探究会阴部神经阻滞麻醉在分娩中的疗效观察。方法选择2012年3月—2013年3月阴道分娩的初产妇100例,随机分为观察组及对照组各50例。观察组采用会阴神经阻滞麻醉,对照组不使用会阴神经阻滞麻醉,比较二组第二产程时间、会阴裂伤情况、疼痛情况、新生儿情况等。结果观察组第二产程(81.65±14.32)min,胎头拨露到胎头、胎肩娩出时间(28.41±4.49)min;对照组第二产程(94.48±17.94)min,胎头拨露到胎头、胎肩娩出时间(33.34±4.36)min,二组比较差异均有统计学意义(P<0.05)。观察组会阴完整率60.0%,对照组34.0%,差异有统计学意义(P<0.05);观察组会阴侧切率20.0%,对照组42.0%,差异有统计学意义(P<0.05)。观察组会阴裂伤主要以Ⅰ度为主,无Ⅲ度裂伤情况,对照组会阴裂伤主要以Ⅲ度为主,有1例发生Ⅲ度裂伤,二组比较差异有统计学意义(P<0.01)。观察组产科操作疼痛评分(3.5±1.0)分,对照组(4.8±1.2)分,观察组显著低于对照组,差异有统计学意义(P<0.01)。二组产妇对产科操作镇痛效果比较,观察组80.0%的产妇不疼痛,仅有4.0%的产妇感到不可忍受,对照组有20.0%的产妇感觉不可忍受,二组比较差异有统计学意义(P<0.01)。观察组平均住院时间(3.5±1.1)d,观察组显著短于对照组,差异有统计学意义(P<0.01)。结论会阴神经阻滞麻醉应用于阴道分娩的接生过程中,能够缓解镇痛,降低会阴侧裂率,缩短第二产程,值得推广。更多还原

【Abstract】 Objective To discuss clincal efficacy of perineal anesthesia during labour.Methods Selected100 cases of vaginal delivery primipara from March 2013 to March 2014 were divided into the observation group and the control group randomly,each group with50 cases.Observation group was treated with perineal anesthesia,while the control group was without perineal anesthesia.The second stage of labor,perineal laceration,the pain,and newborns outcomes of two groups were compared.Results The second stage of labor of observation was(81.65±14.32)min,dial fetal head exposed to the fetal head,fetal shoulder delivery time was(28.41±4.49)min;The second stage of labor of control was(94.48±17.94)min,dial fetal head exposed to the fetal head,fetal shoulder delivery time was(33.34±4.36)min;There was significant difference between two groups(P<0.05).Perineum complete rate of observation was 60.0%,and control group was 34.0%,which showed significant difference between two groups(P<0.05);Episiotomy rate of observation was 20.0%,and control group was 42.0%,which showed significant difference between two groups(P<0.05).In observation group,perineal laceration mainly was degreeⅠ,with no degreeⅢ,but in control group,perineal laceration mainly was degreeⅡ,with1 cases of degreeⅢ,which showed significant difference between two groups(P<0.01).VAS score of observation was 3.5±1.0,and control group was 4.8±1.2,which showed significant difference between two groups(P<0.01).In observation group,80.0% puerperal was without pain during obstetric operation,and only 4.0% could not stand,but 20.0% puerperal in control group could not stand,which showed significant difference between two groups(P<0.01).The average length of stay of observation was(3.5±1.1)d,which was shorter than control group(P<0.01).Conclusion Perineal anesthesia during labor can ease pains,reduce the rate of perineal sylvian,and shorten the second stage,worthy of clinical promotion.更多还原