无痛中期妊娠引产的临床观察

摘要

Objective To investigate the effect of painless induced labor of middle pregnancy with epidural anesthesia. Methods 60 cases of primipara or pregnant woman 7 years ago with single pregnancy and primiparity and being painless induced labor of middle pregnancy in my hospital from June in 2013 to September in 2014. All cases were randomized into two groups, group A(the dilatation of cervix 2 cm, the voluntary choice painless labor with epidural anesthesia, n=30 cases), group B(the painless induced labor of middle pregnancy for routine, n=30 cases).The pregnant women who painless induced labor of middle pregnancy by mifepristone and rivanol. Respectively, the situation of visual analogue scale (VAS) and the situation of delivery and the satisfaction degree of pregnant woman between tow groups. Results There were no significant difference in the mete of flooding and the retained placenta and the retention of urine between A group and B group(P>0.05).There were significant difference in the VAS at the dilatation of cervix 2 cm (T2) and the VAS at the placental expulsion (T3) and the regular uterine contraction to delivery time and the satisfaction degree of pregnant woman between A group and B group(P<0.05). The VAS at T2 and T3 were significantly lower in Group A Group A are (2.57±1.10)minand(3.57±0.90)min, Group B are(5.00±1.95)minand (4.30±1.2)min.The regular uterine contraction to delivery time was significantly lower in Group A(Group A is(154.83±28.99)min, Group B is(216.17±53.85)min.The satisfaction degree of pregnant woman was significantly lower in Group B Group A is 73.33%, Group B is 43.33%.Conclusion The painless induced labor of middle pregnancy with epidural anesthesia can relieve the pain of pregnant woman and decrease the process of parturition. To improve the satisfaction of pregnant women.%目的：研究单次硬膜外麻醉无痛中期妊娠引产的疗效。方法选择2013年6月～2014年9月自愿在我院接受中期妊娠引产的单胎初产或者初产分娩后＞7年的孕妇60例。A组宫口扩张约2cm，自愿选择单次硬膜外麻醉无痛分娩30例，B组常规中期妊娠引产30例。中期妊娠引产均采用米非司酮联合利凡诺的方式。观察两组孕妇疼痛评分情况、分娩情况以及孕妇满意度情况。结果两组相比，产后出血量（mL）、胎盘胎膜残留和尿潴留的发生率差异均无统计学意义（P＞0.05）。宫口扩张约2cm后40min时（T2）疼痛评分、胎盘娩出时（T3）疼痛评分、规律宫缩至分娩时间（min）及孕妇满意度均差异有统计学意义（P＜0.05）。疼痛评分：A组T2和T3分别为（2.57±1.10）min和（3.57±0.90）min，B组T2和T3分别为（5.00±1.95）min和（4.30±1.2）min，A组疼痛发生率低；孕妇满意度：A组为73.33%， B组为43.33%，A组的孕妇满意度高；A组规律宫缩至分娩时间（min）与B组相比较差异有统计学意义（P＜0.05），A组为（154.83±28.99）min，B组为（216.17±53.85）min，A组的分娩时间更短。结论单次硬膜外麻醉无痛中期妊娠引产能够有效的减轻孕妇的分娩疼痛，缩短产程，提高孕妇满意度。