硬膜外镇痛分娩中发生持续性枕后位的临床分析  

Clinical observation of incidence of persistent occipitoposterior position in delivery after epidural analgesia

作　　者：孟志宁[1] 吕秀芳[1] 刘筑玉[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院,广东深圳518133

出　　处：《中国妇幼健康研究》2012年第1期92-93,共2页Chinese Journal of Woman and Child Health Research

摘　　要：目的 探讨在硬膜外镇痛分娩中持续性枕后位的发生率及其对分娩方式、母婴结局的影响.方法 回顾性分析1 472例硬膜外镇痛分娩孕妇的分娩方式、催产素使用、产后出血等资料,与同期3 371例非镇痛分娩孕妇进行对比分析.结果 镇痛组持续性枕后位发生率（11.0%）及第一、二产程催产素使用率（64.0%、36.6%）显著增高,非镇痛组分别为4.2%、33.2%、18.0%,两组比较差异均有统计学意义（χ2值分别为68.146、148.747、114.762,均P〈0.05）.镇痛组剖宫产率（20.9%）较非镇痛组（25.0%）低,两组比较差异有统计学意义（χ2=5.835,P〈0.05）.两组间产后出血率及新生儿窒息率比较差异均无统计学意义（均P〉0.05）.结论 硬膜外镇痛分娩过程中应做到仔细观察,早诊断,重视持续性枕后位的发生,及时处理,提高阴道分娩率.Objective To discuss the incidence of persistent occipitoposterior position in delivery after epidural analgesia and the effects on delivery mode and mother-infant outcomes. Methods Delivery mode, oxytocin use and postpartum hemorrhage of 1 472 cases of epidural analgesia delivery were retrospectively analyzed and were compared with those of 3 371 cases of normal delivery. Results In analgesic group the rate of persistent occipitoposterior position （ 11.0% ） and utilization rate of oxytocin at first and second delivery process （64.0% , 36.6% ） were significantly higher and they were 4.2% , 33.2% and 18.0% , respectively in non-analgesic group. The differences in two groups had statistical significance （X2 was 68. 146, 148. 747 and 114. 762, respectively, all P 〈 0.05 ）. The cesarean section rate of analgesic group （20.9%） was lower than that of non-analgesic group （25.0%）, and the difference was statistically significant （X2 = 5. 835, P 〈 0.05 ）. But the differences in bleeding rate after delivery and neonatal suffocation rate between two groups were not statistically significant （both P 〉 0.05）. Conclusion Conditions in the process of delivery with epidural analgesia should be observed carefully and diagnosed early. Pay more attention to the occurrence of persistent occipitoposterior position and provide timely treatment so as to improve vaginal delivery rate.

关 键 词：硬膜外镇痛分娩 持续性枕后位 发生率 阴道分娩率 

分 类 号：R714.4[医药卫生—妇产科学]