经皮神经电刺激联合硬膜外阻滞全产程分娩镇痛的安全性及有效性[摘要]目的比?^全产程硬膜外分娩镇痛与经皮神经电刺激联合硬膜外阻滞全产程分娩镇痛的安全性及有效性。方法选择2016年12月～2017年12月在天津市中心妇产科医院分娩的产妇200例为研究对象，采用随机数字表法分为全产程硬膜外分娩镇痛组（B组）和经皮神经电刺激联合硬膜外阻滞全产程分娩镇痛组（C组），每组各100例。剔除中转剖宫产的产妇后，B组最终纳入85例，C组纳入93例。B组产妇自潜伏期（规律宫缩）即实施硬膜外分娩镇痛，C组产妇于潜伏期行经皮神经电刺激镇痛，进入活跃期（宫口开3cm）同时行硬膜外阻滞镇痛，方法同B组。分别记录两组产妇实施镇痛后宫口开2、4、6、8cm和10cm的疼痛视觉模拟评分（VAS）；记录各组产妇第一产程时间及两组新生儿脐动脉血pH值、二氧化碳分压、氧分压、乳酸、剩余碱（BE）值及娩出后lmin的Apgar评分。结果B组产妇剖宫产率高于C组，第一产程时间长于C组，差异均有统计学意义（P<0.05）。宫口开2cm时B组VAS评分低于C组（P<0.05）；宫口开4cm和6cm时两组VAS评分比较，差异无统计学意义（P>0.05）；宫口开8cm和10cm时B组VAS评分高于C组，差异有高度统计学意义（P<0.01）。两组新生儿出生后1min的Apgar评分及脐带动脉血血气分析比较，差异无统计学意义（P>0.05）。结论经皮神经电刺激联合硬膜外阻滞全产程分娩镇痛可安全有效地应用于顺产产妇。[关键词]分娩镇痛；电刺激；新生儿[]R741[文献标识码]A[]1673-7210（2018）02（c）-0094-04ThesafetyandefficacyofthewholestageelectricalstimulationcombinedwithepidurallaboranalgesiaLYUNingLYUYanLILiDepartmentofAnesthesiology，Tian激nCentralObstetricsandGynecologyHospital，Tian激n300100，China[Abstract]ObjectiveTocomparethesafetyandefficacyofthewholestageepidurallaboranalgesiaandwholestageelectricalstimulationcombinedwithepidurallaboranalgesia.MethodsFromDecember2016toDecember2017，atotalof200casesofpuerperasinTian激nCentralObstetricsandGynecologyHospitalwereselectedastheresearchobjectsanddividedintothewholestageepidurallaboranalgesiagroup（groupB）andthewholestageelectricalstimulationcombinedwithepidurallaboranalgesiagroup（groupC）bytherandomnumbertable，with100casesineachgroup.Thepuerperaswhoreceivedcaesareansectionwereeliminated，with85casesingroupBand93casesingroupC.GroupBwasgivenepidurallaboranalgesiainthelatentphase（afteruterinecontractionsregularly），groupCwasgivenelectricalstimulationinincubationperiodoffirstproductionprocessandepidurallaboranalgesiaafteruterinecontractionsregularlyasingroupB（whentheuteruscervixwas3cm）.Thetimeforthefirststageoflaborandthescoresofvisualanaloguescale（VAS）attheuteruscervix2，4，6，8cmand10cmwererecorded.Thebloodgasanalysisofumbilicalarteryofneonates（includespHvalue，carbondioxidepartialpressure，oxygenpartialpressure，lacticacid，residualalkali.）andtheApgarscoreafter1minofdeliverywererecorded.ResultsThecesareansectionrateingroupBwashigherthanthatofgroupC，thefirststageoflabortimeingroupBwaslongerthanthatofgroupC，withstatisticallysignificantdifferences（P<0.05）.Attheuterinecervix2cm，theVASscoreingroupBwaslowerthanthatofgroupC，withstatisticallysignificantdifference（P<0.05）.Therewerenostatisticallysignificantdifferencesattheuterinecervix4cmand6cmbetweenthetwogroups（P>0.05）.Attheuterinecervix8cmand10cm，theVASscoresingroupBwerehigherthanthoseofgroupC，withstatisticallysignificantdifferences（P<0.01）.Therewerenostatisticallysignificantdifferencesbetweenthetwogroupsinthebloodgasanalysisofumbilicalarteryandthe1minApgarscoreafterbirth（P>0.05）.ConclusionThewholestageelectricalstimulationcombinedwithepid...