目的 观察罗哌卡因联合芬太尼硬膜外麻醉镇痛用于无痛分娩效果及其对应激的影响.方法 按照产妇是否接受无痛分娩,将456例初产妇分为观察组(198例)和对照组(258例),观察组给予无痛分娩.比较2组的镇痛效果和不良反应的发生情况.结果 观察组各产程的视觉模拟疼痛评分、血清C反应蛋白和剖宫产率较对照组明显降低(P＜0.01),血清前白蛋白水平和自然分娩率较对照组明显升高(P＜0.05,P＜0.01).2组助产率、产后2h出血量和婴儿出生后Apgar评分差异无统计学意义(P＞0.05).结论 罗哌卡因联合芬太尼进行无痛分娩疗效显著,不良反应小,可减轻产痛引发的应激反应.%Objective To observe the effect of epidural analgesia with ropivacaine and fentanyl for painless childbirth and its impact on stress. Methods According to whether or not to accept the painless childbirth, 456 primiparas were divided into observation group (198 cases ) and control group (258 cases ). The observation group was given epidural analgesia for painless childbirth. The analgesic effect and incidence of adverse reactions were observed in two groups. Results After treatment, the visual analogue pain score, the levels of C - reactive protein and the rate of cesarean section in observation group were significantly lower compared with the control group ( P < 0. 01 ). The levels of serum prealbumin and the rate of natural birth were significantly higher than those in the control group( P < 0. 05 ,P < 0. 01 ). The rate of midwifery, the amount of post - partum bleeding in two hours and the Apgar score of infant were not statistically different in two groups( P > 0. 05 ). Conclusion The effect of epidural analgesia with ropivacaine and fentanyl for painless childbirth is obvious, the side effects are less, it can ease the stress response caused by labor pain during delivery.
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