硬膜外双管阻滞和单管阻滞麻醉用于初产妇分娩镇痛的效果比较

摘要

Objective To compare the analgesic efficacy of double -catheter and single -catheter epidural block for uniparas during labor.Methods A total of 80 cases of natural childbirth were collected from January of 2013 to June of 2014 in the South-ern District hospital of Zhongshan,which were randomly divided into two groups:double -catheter epidural block(n =40)and single -catheter epidural block(n =40).The pain visual analogue scale (VAS),neonatal evaluation,Bromage score,delivery situation,anesthesia -related complication rate were compared between two groups.Results Compared with single -catheter epidural block group,VAS score,oxytocin utilization and lower cesarean section rate of double -catheter epidural block group were lower with shorter labor time,and the differences were statistically significant (P <0.05).The Bromage score,newborn Apgar score,anesthesia -related complication rate in the two groups had no statistical significance (P >0.05).Conclusion Double -catheter epidural block can provide better analgesia efficacy than single -catheter epidural block during labor,which can reduce cesarean section rate and shorten the duration of labor.%目的：对比分析硬膜外双管阻滞和单管阻滞麻醉用于初产妇分娩镇痛的效果。方法将2013年1月至2014年6月中山市南区医院收治的初次自然分娩者共80例，根据麻醉方式不同将患者随机分为双管组（行双管硬膜外阻滞）和单管组（行单管硬膜外阻滞），各40例。比较两组患者的疼痛视觉模拟评分（VAS）、新生儿评分、Bromage 评分、分娩情况、麻醉相关并发症发生率。结果与单管组比较，双管组 VAS 评分、缩宫素使用率和剖宫产率更低，产程时间更短，差异均有统计学意义（P ＜0．05）。两组 Bromage 评分、新生儿 Apgar 评分、麻醉相关并发症发生率比较，差异均无统计学意义（P ＞0．05）。结论与单管阻滞麻醉比较，硬膜外双管阻滞具有更好的镇痛效果，能降低剖宫产率，并缩短产程。