超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察

颜娅; 何才; 梅杨; 杨立伟; 张萍; 李有长

doi:10.16016/j.1000-5404.201811112

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超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察

临床医学 | 更新时间：2026-01-09

- 超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察
- Efficacy of ultrasound-guided pudendal nerve block for labor analgesia and perineal protection
- 第三军医大学学报 2019年41卷第10期页码：987-990
- 作者机构：
  
  1.401147重庆，重庆市妇幼保健院：麻醉科
  2.401147重庆，重庆市妇幼保健院：产科
- 作者简介：
  
  [ 李有长，E-mail：1102690108@qq.com LI Youchang, E-mail:1102690108@qq.com
- 基金信息：
  
  重庆市卫生计生委医学科研项目(2017MSXM112)
- DOI：10.16016/j.1000-5404.201811112
  中图分类号： R445.1;R614.4;R714.3
- 收稿：2018-11-16，
  
  修回：2019-01-13，
  
  纸质出版：2019-05-30
- 稿件说明：
移动端阅览
颜娅, 何才, 梅杨, 等. 超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察[J]. 第三军医大学学报, 2019,41(10):987-990.

Ya YAN, Cai HE, Yang MEI, et al. Efficacy of ultrasound-guided pudendal nerve block for labor analgesia and perineal protection[J]. Journal of Third Military Medical University, 2019, 41(10): 987-990.
颜娅, 何才, 梅杨, 等. 超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察[J]. 第三军医大学学报, 2019,41(10):987-990. DOI： 10.16016/j.1000-5404.201811112.

Ya YAN, Cai HE, Yang MEI, et al. Efficacy of ultrasound-guided pudendal nerve block for labor analgesia and perineal protection[J]. Journal of Third Military Medical University, 2019, 41(10): 987-990. DOI： 10.16016/j.1000-5404.201811112.

摘要

目的

探讨超声引导下阴部神经阻滞用于分娩镇痛的效果及会阴保护作用。

方法

选取2017年7-12月在我院经阴道分娩的初产妇80例，采用随机数字表法分为两组(超声组与盲探组)，每组各40例。评价超声下阴部神经解剖结构清晰度，比较两组产妇第二、三产程的镇痛效果、会阴保护情况、器械助产率及阴部神经阻滞相关并发症等指标。

结果

超声组产妇的阴部神经解剖结构清晰度优良率达95%，两组产妇阴部神经阻滞后疼痛均得到明显缓解(

0.05)；超声组产妇的第二、三产程镇痛效果均优于对照组(

0.05)；超声组产妇会阴撕裂伤程度、会阴侧切率及局部血肿发生率均明显低于盲探组(

0.05)；两组产妇器械助产率差异无统计学意义(

0.05)。

结论

第二产程应用超声引导行阴部神经阻滞能够发挥良好的分娩镇痛效果及会阴保护作用，降低局部血肿的发生率，有利于产妇的分娩后恢复。

Abstract

Objective

To investigate the efficacy of ultrasound-guided pudendal nerve block in labor analgesia and its effect for perineal protection.

Methods

Eighty primiparas undergoing vaginal delivery with pudendal nerve block between July and December

2017 in our center were randomized into 2 groups

in which pudendal nerve block was performed under ultrasound guidance (

=40) or by blind exploration (

=40). The articulation of the anatomical structures of the perineal nerve displayed by ultrasound was evaluated. The Visual Analog Scale (VAS) scores in the second and third stages of labor

perineal protection

instrument-assisted delivery rate

and complications related with perineal nerve block were compared between the 2 groups.

Results

The articulation of the anatomical structures of the perineum nerve was excellent in 95% of the patients in the ultrasound group. Compared with the scores before analgesia

the VAS scores during labor were significantly reduced in both groups (

0.05). Compared with pudendal nerve block by blind exploration

ultrasound guidance produced better analgesic effect (

0.05) with significantly reduced perineal laceration rate

episiotomy rate

and incidence of local hematoma (

0.05). The instrument- assisted delivery rate did not differ significantly between the 2 groups (

0.05).

Conclusion

Labor analgesia with ultrasound-guided pudendal nerve block during the second stage of labor provides more effective analgesia and perineal protection and reduces the incidence of local hematoma to promote the recovery of primiparas.

关键词

Keywords

references

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