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无痛分娩在中国普及难 京沪多家三甲医院表示不开展

2017-09-12 04:36:06   新京报

一次产检打消了王芳的顾虑。排队时,旁边一位孕妇问医生,打无痛分娩针是否有后遗症?医生当即回答她说,打无痛分娩针后的副作用没有我们想象得那么可怕,麻药的剂量也只是剖宫产麻药剂量的十分之一,对身体副作用没有那么大。

南兴东坦言,医疗操作都会有风险,常见严重副作用主要是腰痛、头痛头晕以及神经损伤,但“这些副作用发生概率总体上都很低,临床上会尽量预防,即使发生也是一次性的,可以痊愈的,后遗症非常罕见。”

他以自己十余年的临床经验举例,该院亚运村院区曾在2015年进行一次椎管内麻醉产妇的电话随访,近100例产妇,只有几例产妇反馈有腰痛,且主要与合并腰间盘突出、腰肌劳损、产后休息欠佳等相关。

至于研究统计,他表示:“腰痛发生的概率文献称不足1%,头痛头晕则是千分之一的概率,而神经损伤概率则仅为万分之一。”另外,民航总医院前妇产科主任吕玉人告诉记者,穿刺失败会出血,做了药物麻醉产后也会有疼痛,但“这些都是可以恢复的,无痛分娩相对还是很安全的。”

尴尬的普及率

中国首例无痛分娩案例已不可考。据“无痛分娩中国行”发起人胡灵群等人2013年发表的论文,1959年有关于针灸分娩镇痛的报道,1964年现北京大学医学院第一附属医院张光波在第一届全国麻醉学术会议上报道采用低浓度局部麻醉药用于无痛分娩,比1953年英国使用分娩镇痛晚了100多年。

对于无痛分娩在我国的普及范围,多位从医的采访对象均向记者表示,通常妇产专科医院的普及度高于综合医院,民营医院普及度高于公立医院,发达地区普及度比偏远地区高,与医疗资源有关。

新京报记者致电北京、上海等地部分三甲综合医院,北京大学第三医院、地坛医院、上海交通大学医学院附属瑞金医院、上海交通大学医学院附属仁济医院(东部)、上海市第一人民医院(虹口)等医院明确表示不开展无痛分娩。

浙江大学医学院附属第一医院相关人员表示可以提供无痛分娩,需产妇自己提出,医生再根据情况进行评估是否进行。北京安贞医院虽然可以做,但只有周一至周五的白天可以提供。

与综合医院相比,妇产专科医院及民营医院无痛分娩的普及率较高。记者通过调查了解到,中国福利会国际和平妇幼保健院、北京妇产医院均可提供无痛分娩,产妇在孕妇学校时便可得知相关技术,如果在生产时提出需求,经医生评估后便可进行。

北京妇产医院计生科副主任陈素文告诉记者,只要产妇提出且符合条件,随时都可以接受无痛分娩技术。

至于私立医院,普及率更高。南兴东透露,他们医院单独一次无痛分娩收费约5000多元,每个月约150名产妇中,约有100名会选择顺产,而其中便有97至98人会做无痛分娩。

浙江杭州人李乐扬(化名)曾在2014年和2017年生产时,均提出要打无痛分娩,但均被医院以麻醉师不够或没空为由拒绝。她依然对当初医院的态度耿耿于怀,那是她所在区唯一一所妇产专科医院。

曾在北京某医院生产的耿佳(化名)也提出了打无痛分娩,但最终医院并未满足她的要求,只是在“疼到快死时打了一针安定注射液,依然无感,继续痛到差点咬掉老公的手指头”。

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