中期引产镇痛方法的临床比较

目的 评价硬膜外镇痛、腰麻联合硬膜外镇痛、静脉镇痛用于中期引产的临床效果和不良反应。方法 选取本院收治的因有妊娠合并症及计划外妊娠要求镇痛终止妊娠者240例。随机分为3组，I组为硬膜外镇痛组，II组为腰麻联合硬膜外镇痛组，III组为静脉镇痛组，每组80例。同期非镇痛引产者228例作为对照组（D组）。于镇痛开始前及镇痛后0.5h时记录孕妇生命体征、VAS评分、孕妇满意度、引产时间及并发症情况。结果与D组比较，其余3组引产时间缩短（P〈0.05）；I、II和III组镇痛优良率均高达96％以上，优于D组（P〈0.05）；各组间孕妇生命体征平稳，无统计学差异（P〉0.05）；与D组比较，其余3组并发症总数较多（P〈O.05）；III组恶心呕吐发生率低，呼吸抑制和嗜睡发生率高（P〈0.05）。结论对于中期引产，硬膜外镇痛、腰麻联合硬膜外镇痛、静脉镇痛均具有良好的镇痛效果，但静脉镇痛具有创伤小、方便快捷等优势。

Comparison of different analgesia methods for metaphase induced labor

Objective To evaluate the clinical effects and adverse reactions of epidural analge- sia, combined spinal-epidural analgesia and intravenous analgesia for metaphase induced labor. Meth- ods Two hundred and forty pregnant women induced labor for complications of pregnancy or unplanned pregnancy were randomly divided into 3 groups for analgesia; epidural analgesia group （group I）, combined spinal-epidural analgesia group （group II） and intravenous analgesia group （group Ⅲ ）, 80 cases in each. 228 pregnant women induced labor were non-analgesia as a control group （group D） during the same period. Vital signs, VAS, satisfaction rate, induction time and complications were recorded at the times before the analgesia and 0.5 h after the analgesia. Results Compared with group D, the induction times were shortened in the other groups（P〈0. 05）; the excellent and good rates were aboved 96% in group I, II and III, which were better than those in group D. The incidences of nausea and vomiting were lower, while the incidences of respiratory depression and sleepiness was higher in group III （P〈0.05）. Conclusion Epidural analgesia, com- bined spinal-epidural analgesia and intravenous analgesia all have good analgesic effects for metaphase induced labor, but intravenous analgesia with the advantages of noninvasive and convenient.