目的:探讨专职护士程序化管理麻醉无菌耗材的应用效果.方法:选取麻醉医师自行准备手术所需的麻醉无菌耗材模式作为对照组(n=100);由专职护士程序化管理麻醉无菌耗材,于手术前30 min发放麻醉无菌耗材模式作为观察组(n=100),比较2组不同麻醉方式的无菌耗材准备时间、麻醉医师满意度、在岗率、耗材有效期合格率、漏费率.结果:观察组不同麻醉方式的无菌耗材准备时间、漏费率均明显低于对照组(P<0.01);观察组麻醉医师满意度、在岗率、耗材有效期合格率明显高于对照组(P<0.01).结论:专职护士程序化管理麻醉无菌耗材提高了麻醉医师的满意度和工作效率,缩短了麻醉准备时间,保证无菌耗材数量齐全、质量完好,无丢失、无漏记、无少记及无过期情况的发生,保障了医疗安全,值得在临床中推广应用.

目的 探讨不同靶浓度羟考酮靶控输注对老年患者全麻插入喉罩时的麻醉效果及丙泊酚Cp50的影响.方法 收集80例ASAⅠ～Ⅱ级择期全麻插入喉罩手术患者资料,年龄60～79岁.按照羟考酮靶浓度、患者年龄分为四组,A 组:0.2 mg/L,60～69岁;B 组:0.15 mg/L,60～69岁;C 组:0.2 mg/L,70～79岁;D组:0.15 mg/L,70～79岁.待羟考酮血浆和效应室浓度平衡后,以血浆靶浓度TCI输注丙泊酚,在意识消失后给予咪达唑仑30 μg/kg、顺式阿曲库铵0.2 mg/kg,4 min后插入喉罩.依据改良后的Dixon上下交叉序贯法确定丙泊酚的血浆靶浓度.观察并记录麻醉诱导前(T0)、插入喉罩前1 min(T1)、插入喉罩时(T2)、插入后1 min(T3)时的平均动脉压、心率和BIS值.结果 四组患者性别、年龄、体重指数(BMI)等无统计学意义(P＞0.05).四组患者中T1时点的心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS)值较T0均有降低,四组之间生命体征比较差异均无统计学意义(均P＞0.05).四组患者丙泊酚Cp50分别为:A组(3.95+0.53)μg/ml,B 组(2.85+0.57)μg/ml,C 组(3.10+0.48)μg/ml,D 组(1.95+0.58)μg/ml.与 A 组比较,B组、C组、D组丙泊酚Cp50明显降低(P＜0.05);D组丙泊酚Cp50与C组比较明显降低(P＜0.05),以上结果差异均有统计学意义.B组和C组比较丙泊酚Cp50差异无统计学意义(P＞0.05).四组患者中低血压和心动过缓的发生无统计学意义(均P＞0.05).结论 在全麻插入喉罩的过程中,随着患者年龄和羟考酮效应室靶浓度的增加,丙泊酚的Cp50明显降低.

目的 分析右美托咪定复合罗哌卡因行胸椎旁神经阻滞(TPVB)在冠状动脉(冠脉)搭桥手术患者中的应用及对术后镇痛的影响.方法 回顾性分析2016年12月至2019年5月在华北理工大学附属医院行不停跳冠脉搭桥术192例患者的临床资料,将全麻诱导前给予0.35％罗哌卡因30 ml行TPVB的94例列为对照组,给予右美托咪定注射液 1μg/kg+0.35％罗哌卡因30 ml行TPVB的98例列为研究组.比较两组以下指标:ICU滞留时间、拔管时间、住院时间;入室安静状态下(t0)、胸椎旁给药15min(t1)、气管插管即刻(t2)、切皮后5 min(t3)、术毕拔管前(t4)时的平均动脉压(MAP)、心率(HR);术后6、12、24、48 h时的疼痛视觉模拟评分(VAS);循环稳定性、并发症及不良反应.结果 研究组ICU滞留时间、拔管时间、住院时间显著低于对照组(P＜0.01);在t1～t4 时MAP、HR明显低于对照组(P＜0.01);在术后24、48 h时VAS评分明显低于对照组(P＜0.01);术后24 h窦性心动过缓发生率、低血压发生率两组相近(P＞0.05),研究组患者高血压、窦性心动过速发生率明显低于对照组(P＜0.05,P＜0.01);术后24 h两组患者均未出现呼吸抑制、寒战、肺部感染、肺不张;研究组和对照组恶心呕吐(3.06％vs 4.26％,P＞0.05)、感觉异常发生率(2.04％vs 3.19％,P＞0.05)比较差异均无统计学意义.结论 右美托咪定复合罗哌卡因行TPVB在不停跳冠脉搭桥术中应用,有助于维持机体血流动力学稳定,减少高血压及心动过速的发生,且并发症及不良反应少,术后镇痛效果好.

[目的]探讨硬膜外麻醉联合B超引导在单胎妊娠孕妇臀位外倒转中的应用效果.[方法]产前B超诊断为臀位的236例孕妇随机分为两组,每组118例.对照组行传统的膝胸卧位纠正胎位,观察组硬膜外麻醉后,在B超引导下行臀位外倒转纠正胎位.比较两组孕妇臀位矫正情况、分娩方式及并发症的发生情况.分析影响单胎臀位外倒转术成功的因素.[结果]观察组胎位纠正成功率为82.20％(97/118),阴道分娩率为66.10％(78/118),均明显高于对照组的42.37％(50/118)和31.36％(37/118)(P<0.05),而剖宫产率低于对照组[33.90％(40/118)v s 68.64％(81/118)](P<0.05).相比于对照组,观察组胎膜早破发生率低[9.32％(11/118)v s 30.51％(36/118)](P<0.05),而两组胎盘早剥、新生儿窒息及产伤发生率比较差异均无显著性(P>0.05).不同孕周、体质量指数、新生儿体重、羊水指数、臀位类型、胎盘位置与脐带绕颈的外倒转成功率相比较差异无统计学意义(P>0.05),而胎头可探及与先露不入盆外倒转术成功率显著高于胎头不可探及和先露入盆者(P<0.05).[结论]采取硬膜外麻醉联合B超应用于单胎臀位外倒转术,可显著提高胎位纠正成功率和阴道分娩率,降低剖宫产率,保证母婴安全.

目的 研究七氟醚对幼鼠海马发育的神经毒性作用及其机制.方法 按照体重将幼鼠随机分为4组:第1干预组、第2干预组、第3干预组及第4干预组,每组25只.第1干预组暴露于30％O2中;第2干预组暴露于3％七氟醚+30％O2中,前5 min诱导流速为6 L·min-1,然后以1 L·min-1维持,持续4 h;第3干预组给予0.9％NaCl,随后处理与第1干预组相同;第4干预组幼鼠腹腔注射40 mg·kg-1的LY294002,七氟醚暴露过程与第2干预组一致.用蛋白质印迹法检测海马磷脂酰肌醇3激酶(PI3K)、蛋白激酶B(Akt)和缝隙连接蛋白43(Cx43)的蛋白表达量.结果 第1干预组、第2干预组、第3干预组和第4干预组幼鼠第7天海马脑组织中Cx43蛋白相对表达量分别为0.69±0.09,0.72±0.10,0.44±0.05和0.61±0.05;这4组的PI3K蛋白相对表达量分别为0.88±0.07,1.13±0.11,0.62±0.04和0.71±0.06;这4组的Akt蛋白相对表达量分别为1.38±1.03,1.51±1.01,0.70±0.06和0.74±0.06.上述指标:第2干预组与第1干预组比较,差异均有统计学意义(均P<0.05);第4干预组与第2干预组比较,差异均有统计学意义(均P<0.05).结论 七氟醚可能通过激活PI3K/Akt信号通路增加Cx43蛋白表达,并诱导海马神经元凋亡,增加幼鼠认知功能损伤.

目的 探讨两种麻醉方式下老年腹腔镜结直肠癌根治术患者的肺内分流及氧合功能改变.方法 选取该院在两种麻醉方式下行腹腔镜下结直肠癌根治术的老年患者60例为研究对象,分为全身麻醉组(A组)、硬膜外阻滞复合全身麻醉组(B组),每组30例.观察并比较两组患者入室后10 min(T0)、气管插管后10 min(T1)、气腹1 h(T2)、气腹2 h(T3)、关闭气腹后10min(T4)、拔管时(T5)时的平均动脉压(MAP)、心率(HR)及中心静脉压(CVP).比较T0、T2、T3、T5时刻的肺内血分流率(QS/QT)、乳酸(ABL)及一氧化氮合酶(iNOs).记录两组患者术中丙泊酚、瑞芬太尼的用药量及苏醒时间.结果 A组患者QS/QT在T2、T3、T5时刻明显高于B组(P＜0.01),ABL在T3、T5时刻高于B组(P＜0.05).A组和B组患者QS/QT在T2、T3、T5时刻均明显高于T0时刻(P＜0.01).A组患者ABL在T3、T5时刻明显高于T0时刻(P＜0.01),B组患者ABL在T5时刻高于T0时刻(P＜0.05).A组患者HR、MAP在T2、T3、T5时刻均高于B组(P＜0.01),CVP在T2、T3时刻高于B组(P＜0.01).A组患者丙泊酚、瑞芬太尼用量,苏醒时间及拔管时间明显高于B组(P＜0.01).结论 硬膜外阻滞复合全身麻醉可降低老年腹腔镜结直肠癌根治术患者术中的肺内分流,改善氧合功能.

目的:研究不同麻醉药物对老年骨科手术患者术后认知功能的影响及机制.方法:2015年4月-2018年9月选取行择期骨科手术老年患者160例,随机分为两组,各80例.对照组给予异氟烷进行维持麻醉;试验组给予七氟烷进行维持麻醉.对比两组麻醉效果.结果:对照组术后苏醒时间明显长于试验组,认知功能评分明显低于试验组,差异有统计学意义(P<0.05).两组麻醉时间、手术时间和精神状态评分比较,差异无统计学意义(P>0.05).结论:对老年骨科手术患者行七氟烷吸入性麻醉药物进行维持麻醉,能有效缩短患者苏醒时间,并降低患者认知功能障碍,其主要机制可能与老年患者中枢神经系统炎症有直接关系.

Objective To investigate effects of goal-directed fluid therapy on inflammatory cytokines under combined anesthesia.Methods 60 patients undergoing colorectal cancer surgery,aged 60 to 85 years old,which were classified as American Society of Anesthesiology(ASA)classⅡ~Ⅲ,were randomly assigned to Goal-directed fluid therapy group(group G,n = 30)and central venous pressure liquid management group(group C,n = 30). Life sign and BIS indexes were collected at the time points,before surgery(T1),after the start of the operation (T2),one hour after surgery(T3),after the operation(T4).Hemodynamic indexes were recorded.Two milliliter blood sample were phlebotomized for evaluation of TNF-α and IL-6 from each patient at T1,T3,T4.The infusion volume, the amount of bleeding,the operation time,anal exhaust time,and length of postoperative hospital stay were recorded. Results Comparing information between the two groups,infusion volume and colloid had an obvious decrease than that of group C(P<0.05).SVV and CVP of group G were much stable than group C.The levels of TNF-α and IL-6 of group G were lower than those of group C(P<0.01).The length of anal exhaust time and post-operative hospital stay group G were faster than that of group C(P<0.01).Conclusions Goal-directed fluid ther-apy is superior on fluid administration. It can reduce the release of IL-6 and TNF-α. It is beneficial to elderly colorectal cancer patients with hypertension.

目的 探讨未发生术后认知功能障碍(POCD)的患者是否存在脑功能受损及联合麻醉对老年腹部手术患者的脑保护作用.方法 采用回顾性分析方法,选择行开腹腹部肿瘤手术,术后1 d经MMSE量表评定未发生POCD的老年患者60例,年龄65～80岁,ASA分级Ⅰ ～Ⅲ级,其中全麻联合硬膜外组(GE组, n=30),单纯全麻组(G组,n=30).GE组患者在全麻诱导前行硬膜外穿刺置管,麻醉平面满意后再进行全麻诱导.G组直接全麻,GE组根据血流动力学变化适当调整诱导剂量.记录入室静卧5 min(T0)、气管插管后(T1)、手术切皮时(T2)、探查(T3)、缝皮(T4)、拔管(T5)的HR、MAP.于术前1 d(T6)、手术1 h(T7)、手术2 h(T8)、术毕(T9)采取静脉血检测S100β、NSE浓度.记录手术时间、苏醒时间、拔管时间、定向力恢复时间,出室前对患者进行Steward评分.结果 GE组血流动力学比G组稳定;两组T7、T8、T9时刻S100β及NSE浓度较T6均有所升高(P＜0.01),同时刻GE组小于G组,差异有统计学意义(P＜0.01);术后苏醒时间、拔管时间、定向力恢复时间GE组均短于G组,差异有统计学意义(P＜0.01);出室前Steward评分GE组优于G组,差异有统计学意义(P＜0.05).结论 经MMSE量表评定未发生POCD的患者,仍存在一定程度的脑损伤且联合麻醉较单纯全麻对老年患者脑功能一定的保护作用,术中血流动力学更平稳.

目的 观察以每搏变异度(SVV)为指导的液体治疗对全麻复合硬膜外麻醉下老年腹腔镜结肠癌根治术患者肠道屏障的影响,并探讨其机制.方法 选取行全麻复合硬膜外麻醉下腹腔镜结肠癌根治术的老年患者120例.根据随机数字表法分为两组各60例,S组以SVV为指导进行液体治疗,C组以中心静脉压(CVP)为指导进行液体治疗.记录两组手术时间、液体输入量、出血量、尿量,检测两组在麻醉前(T0)、气腹建立后(T1)、标本切除时(T2)、手术结束时(T3)的血流动力学指标[平均动脉压(MAP)、心脏指数(CI)、中心静脉压(CVP)、SVV]及微循环灌注指标[中心静脉血氧饱和度(ScvO2)、乳酸(Lac)、氧摄取率估计值(O2ER)、氧输送指数(DO2I)和氧消耗指数(VO2I)].取T0 ～T3及术后第1、3天(T4、T5)患者的中心静脉血,测定肠道屏障功能损伤指标血清二氧化酶(DAO)、D-乳酸.记录患者排气时间、住院时间及恶心、呕吐情况.结果 与C组比较,S组液体总量、晶体量均减少(P均＜0.05),但胶体量、尿量均增多(P均＜0.05).与To时比较,两组各时点CVP、VO2I、Lac、ScvO2、DO2I、O2ER均升高(JP均＜0.05),SVV、CI、MAP均降低(P均＜0.05).与C组比较,S组在T1～T3时MAP、CVP均降低(P均＜0.05),CI、ScvO2、SVV均升高(P均＜0.05);在T2、T3时VO2I、Lac均降低(P均＜0.05),DO2I、O2ER均升高(P均＜0.05).与C组比较,S组在T2～T5时的血清DAO、D-乳酸均降低(P均＜0.05).S组住院时间、排气时间均少于C组(P均＜0.05),恶心、呕吐发生率低于C组(P＜0.05).结论 全麻复合硬膜外麻醉下老年腹腔镜结肠癌根治术患者以SVV为指导进行液体治疗,能够维持血流动力学稳定,保证机体组织器官的氧供需求,从而更好地保护肠道屏障,减少胃肠并发症发生.

目的 探讨案例式教学模式在麻醉专业学位研究生培养中的应用效果.方法 选取2012年9月—2016年9月就读我院的40名麻醉专业学位研究生作为研究对象.将其随机分为两组,每组各20名.对照组采用传统教育模式,观察组采用案例式教学模式.比较两组毕业成绩、对教学方法的认可度以及就业单位的满意度.结果 对照组的实践成绩和理论成绩均低于观察组,差异有统计学意义(P<0.05);对照组对教学方法认可度低于观察组,差异有统计学意义(P<0.05);对照组就业单位满意度(75.00％)低于观察组(95.00％),差异无统计学意义(P>0.05).结论 案例式教学模式在全日制麻醉专业学位研究生培养的应用效果确切,能显著提研究生合能力,从而更好地适应临床工作,提高就业单位的满意度.

目的 探讨麻醉护士主导的镇痛管理对分娩产妇的镇痛效果.方法 选择2017年9～11月华北理工大学附属医院收治的临产妇100例,按抽签法随机分为麻醉护理组和助产护理组,每组各50例.助产护理组分娩镇痛时给予分娩产房护理常规,麻醉医师按照预先设置实施镇痛,无麻醉护士参与;麻醉护理组在此基础上由麻醉护士进行围生期镇痛管理.比较两组产妇产程疼痛情况、镇痛满意度及麻醉药物不良反应发生率.结果 麻醉护理组在潜伏期、活跃期、宫口近全时、宫口开全时疼痛评分明显低于助产护理组(P＜0.05);麻醉护理组镇痛满意度明显高于助产护理组(P＜0.05);用药不良反应发生率明显低于助产护理组(P＜0.05).结论 麻醉护士主导的镇痛管理可降低产妇的分娩时疼痛程度,提高产妇对镇痛管理的满意度,确保了母婴安全,值得临床推广.

Objective:To investigate the effect of liquid therapy guided by SVV on the coagulation func-tion of the elderly patients with hypercoagulable colon cancer.Methods:120 cases of senile hypercoagulability (thrombus and elastic map CI>3) were selected in our hospital for radical resection of colon cancer. The ran-dom digital table was used to divide into the liquid treatment group (group S) guided by SVV and the liquid treatment group (group C) guided by CVP,with 60 cases in each group.Recording and analysis of two groups of patients before anesthesia(T0),at the beginning of the operation(T1),one hour of operation(T2),at the end of operation(T3),hemodynamics and oxygen index for four points and thromboelastogram coagulation re-action time (R), blood clotting time (K), blood clot formation rate (alpha angle), maximum amplitude (MA),coagulation index (CI) changes. Results:The amount of liquid input in group S was lower than that in group C (P<0.05). Compared with the C group, the MAP, CVP and Lac of the S group were lower than those of the C group at(T1),(T2) and(T3).SVV,ScvO2,and DO2I were all higher than those in the group (P< 0.05). Compared with T0,the two groups of patients(T1),(T2),(T3),the R value and K value be-came larger,and the alpha and CI were smaller(P <0.05). Compared with the group C,the coagulation fac-tor,fibrinogen and coagulant function were stronger than group S at(T1),(T2) and(T3) (P <0.05).Con-clusion:The liquid therapy guided by SVV is helpful to maintain the stability of coagulation function during the operation of the elderly patients with colon cancer with hypercoagulability,and to correct the hypercoagula-bility.

目的 探讨在每搏变异度(SVV)指导补液的老年结肠癌根治术中,不同BIS值对患者应激反应的影响.方法 将60例静吸复合麻醉下行结肠癌根治术的老年患者随机分为两组(每组n=30):L组(BIS值50~59),D组(BIS值40~49).术中按晶胶比为2:1补液,使SVV维持在8~12.记录患者在入室后20 min(T0)、插管后即刻(T1)、手术开始(T2)、手术开始后60 min(T3)、手术开始后120 min(T4)、手术结束(T5)、拔管后30 min(T6)的心率(HR)、平均动脉压(MAP)的值和心输出量(CO)、每搏量(SV)及SVV在T1、T2、T3、T4、T5时点的值.记录术中补液量及血流动力学波动情况.检测患者T0、T4、T6时点血清皮质醇(Cor)、促肾上腺皮质激素(ACTH)、血糖(Glu)水平.结果 与T0相比,L组患者HR在T4~T6明显增加(P<0.05,P<0.01),MAP在T1、T2显著下降(P<0.05),在T4~T6增加(P<0.05,P<0.01);D组HR各时点无显著变化,MAP在T1~T5下降(P<0.05,P<0.01);同时L组HR在T4~T6明显高于D组(P<0.05),MAP在T3~T6高于D组(P<0.05).D组术中补液量多于L组(P<0.05),高血压发生率低于L组(P<0.05).两组患者Cor、ACTH、Glu在T4、T6均显著升高(P<0.05,P<0.01);L组患者Cor在T4、T6明显高于D组(P<0.05).结论 在SVV指导补液的老年结肠癌根治术中患者麻醉深度维持在BIS值40~49能较好地抑制机体的应激反应,更有利于维持血流动力学的稳定.

Objective To investigate the effects of different depth of anesthesia on ScvO2 and ABL in elderly patients with gastrointestinal cancer. Methods Totally 55 elderly patients undergoing gastrointestinal sur-gery were randomly divided into deep anesthesia group(BIS40-49)(group D,n=27)and light anesthesia group (BIS50-59)(group S,n = 28). While SVV value was fixed,fluid management was conducted while monitoring CVP. HR,MAP,the change of central venous oxygen saturation and lactic acid index were recorded in different time points. Results Propofol dosage in group D and group S indicated statistical significance(P<0.05). ScvO2 in group S in T3~T5 was higher than that in T0 and the difference was statistically significant(P < 0.05). Com-pared with ScvO2 in T3 in group D,that in group S was significantly higher and the difference was statistically sig-nificant(P<0.01),but no significant difference was found in other time point in 2 groups(P>0.05). There was no significant difference between and within ABL groups in each time period(P>0.05). There was no significant difference in terms of other indicators between 2 groups. Conclusions For elderly patients with gastrointestinal surgery,shallow anesthesia can improve tissue oxygenation and reduce the amount of anesthetics.

Objective To explore the effect of pain management by anesthesia nurses on labor analgesia.Methods A total of 100 parturient women in the Affiliated Hospital of North China University of Science and Technology between July and August 2015 were randomly divided into two groups:analgesia group and control group with 50 in each.Both two groups accepted labor analgesia routine maternity nursing.Analgesia group accepted maternal perinatal term pain management in addition to the routine nursing.Then we compared degree of pain during the production process,labor time and perineal injury between the two groups of women.Results The number of women with a labor pain degree of 0-Ⅲ in the analgesia group was respectively 36 (72％),12 (24％),2 (4％) and 0 (0％),and the number in the control group was respectively 23 (46％),17 (34％),8 (16％),and 2 (4％).The above difference between the two groups was statistically significant (Z=-2.908,P =0.004).The number of women with intact perineum,perineal injury of lateral and median cut,and Ⅰ-Ⅲ degree laceration in the analgesia group was respectively 31 (62％),7 (14％),8 (16％),4 (8％) and 0 (0％);and the number in the control group was respectively 21 (42％),12 (24％),10 (20％),7 (14％) and 0 (0％),also with significant difference between the two groups (Z =-2.028,P =0.043).The first and second labor stage of the analgesia group was (462.32±101.27) and (63.58±10.38) minutes,and was (568.27±113.28) and (76.92±11.24) minutes in the control group,with significant differences between the two groups (P＜0.001).There was no statistically significant difference between the two groups in the third labor stage (5.78±3.02) and (5.97±2.96) minutes,(P=0.654).Conclusions The implementation of pain management by anesthesia nurses on labor analgesia can significantly reduce maternal labor pain,shorten the time of labor,and the condition of the perineal injury is mild and easily acceptable.It is worthy of clinical promotion.

Objective To explore the effect of analgesia management on the analgesic effect and the quality of delivery of labor analgesia. Methods The 80 cases were divided into two groups according to the odd number of labor analgesia, the control group without anesthesia nurse labor analgesia, only the anesthesiologist operation, given routine obstetric care. Anesthesia nursing group for labor analgesia by anesthesiologists and nurse by anesthesia on maternal perinatal period health education and pain management, pain score was compared between the two groups (at full dilatation), mode of delivery, postpartum hemorrhage, neonatal asphyxia. Results The total score of pain in the nursing group was 3.9±0.2, while that of the control group was 8.4±0.8, and the difference was statistically significant (t=-38.5872,P=0.000); anesthesia nursing group cesarean delivery, delivery, were 1 cases, 27 cases, 12 cases; the control group were 9 cases, 21 cases, 10 cases, the difference was statistically significant (χ2=7.31, P<0.05) ; the amount of bleedingof anesthesia nursing group (175.5±42.5) ml; the control group was (226.4±52.5) ml, the difference was statistically significant (t=8.621, P<0.05); the incidence of neonatal asphyxia anesthesia nursing group 1 cases (2.5%); the control group was 3 cases (7.5%), the difference was not statistically significant (χ2=0.263, P>0.05). Conclusions During the perinatal period, the labor management and nursing intervention of the parturient women with labor analgesia are significantly reduced, the cesarean section rate is significantly reduced, and the complication rate is reduced.

Objective:To investigate the application value of the stage debugging of anesthesia nurses in labor analgesia. Methods:One hundred puerperas with painless childbirth were randomly divided into the control group and support group according to the labor analgesia. The control group and support group were treated with routine nursing care and perinatal stage debugging of anesthesia nurses in labor analgesia,respectively. The degree of pain( at full dilatation of portio) ,average total amount of drugs by intravenous analgesia, press time and duration of labor in two groups were recorded and compared. Results:The degree of pain,average total amount of drugs by intravenous analgesia and press time in support group were significantly less than those in control group(P<0. 01). The duration of the first and second stage of labor in support group were shorter than those in control group(P<0. 01 and P<0. 05),but the duration of the third stage of labor did not shorten in support group. Conclusions:The stage debugging of anesthesia nurses in labor analgesia can improve the childbirth analgesia effect,reduce the dose of intravenous analgesia drug and shorten labor time,which can be widely used in clinic.

??分娩是产妇必须经历的一个特殊的生理过程，由于子宫收缩、宫口扩张、胎先露下降等引起的疼痛，使产妇子宫平滑肌收缩功能紊乱、宫缩乏力、产程延长；造成产妇焦虑恐惧等不良心理状态，导致血压升高、心率加快，从而阻碍产程进展，难产机会增加，剖宫产率增高［1］。分娩镇痛可以降低产妇分娩痛苦、发挥安全而清醒的镇痛效果，提高分娩期母婴安全性，也有利于剖宫产率的降低［2］。本院2015年1月开展分娩镇痛术，由麻醉护士对分娩镇痛产妇进行围生期的系统护理管理，消除产妇分娩镇痛过程中的焦虑、恐惧感，缓解分娩时疼痛。现报道如下。

Objective To investigate the effect of the application of the process management of anesthesia nurses in the delivery of the labor analgesia. Methods 100 pregnant women in our hospital were randomly divided into experimental group and control group.50 cases in control group were treated with the routine nursing.The experimental group was treated with the pain management. Results In the experimental group,the degree of pain in the experimental group was lower,the comfort degree,the degree of comfort and the low degree of the high degree of cooperation and the low rate of the cesarean section rate was significantly better than the control group. Conclusions Anesthesia pain management application of nurses in delivery analgesia,can significantly reduce the pain of contractions,decreased section palace yield,maternal comfort and with high degree,so as to ensure the safety of mother and infant,is worth the clinical promotion.