持续硬膜外麻醉应用于临产孕妇的分娩镇痛效果及其对妊娠结局的影响  

Labor Analgesia Effect of Continuous Epidural Anesthesia in Pregnant Women and Its Influence on Pregnancy Outcome

作　　者：孟馨[1] 李元涛[1] 胡薇[1] 苏娇玲[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院,广东深圳518028

出　　处：《中国医学创新》2016年第20期50-52,共3页Medical Innovation of China

摘　　要：目的:探讨持续硬膜外麻醉应用于临产孕妇的分娩镇痛效果及其对妊娠结局的影响,为更好的开展硬膜外分娩镇痛提供依据。方法:将600例产妇随机分为镇痛组和对照组,每组300例,镇痛组实行持续性硬膜外分娩镇痛,对照组常规分娩处理。观察并记录两组镇痛效果、产程时间、缩宫素使用情况、分娩方式、产妇不良反应和新生儿情况。结果:镇痛组镇痛效果明显优于对照组,差异有统计学意义(P<0.05);镇痛组妊娠时活跃期、第二产程和总产程较对照组均有所延长,差异均有统计学意义(P<0.05),第三产程时间比较差异无统计学意义(P>0.05);镇痛组催产素使用率明显高于对照组,差异有统计学意义(P<0.05),镇痛组尿潴留发生率较对照组高,差异有统计学意义(P<0.05);两组产妇产后出血情况比较差异无统计学意义(P>0.05),镇痛组孕妇剖宫产率、新生儿窒息率和胎儿宫内窘迫率均低于对照组,差异均有统计学意义(P<0.05)。结论:持续硬膜外麻醉应用于临产孕妇的分娩镇痛能减轻分娩疼痛,降低新生儿窒息率,改善孕妇的分娩结局,但有延长产程,造成尿潴留的危险。Objective： To investigate the continuous epidural anesthesia in pregnant women in labor analgesia and its influence on pregnancy outcome,to better carry out the epidural labor analgesia provides the basis.Method：A total of 600 cases of maternal were randomly divided into two groups,300 cases in each group. The analgesia group was given continuous epidural labor analgesia,the control group were treated with conventional delivery processing.The analgesic effect,labor time,oxytocin use,mode of delivery,maternal adverse reactions and neonatal conditions of the two groups were observed and recorded.Result：The analgesic effect of the analgesia group was significantly better than the control group,the difference was statistically significant（P〈0.05）.The active phase,second stage and total labor of the analgesia group were longer than the control group,the differences were statistically significant（P〈0.05）,the third labor time gap was not statistical significance（P〉0.05）. Oxytocin use rate of the analgesic group was significantly higher than the control group,the difference was statistically significant（P〈0.05）,the incidence of urinary retention in the analgesia group was higher than the control group,the difference was statistically significant（P〈0.05）.Two groups of maternal postpartum bleeding in comparison,the difference was not statistically significant（P〉0.05）.The cesarean section rate,neonatal asphyxia rate and fetal distress rate of the analgesia group were lower than the control group,the differences were statistically significant（P〈0.05）.Conclusion：Continuous epidural anesthesia in pregnant women in labor analgesia can relieve the pain of labor, reduce the neonatal asphyxia rate and improving birth outcomes of pregnant women,but prolonged labor,resulting in the risk of urinary retention.

关 键 词：硬膜外麻醉 分娩镇痛 产痛 产程 分娩结局 

分 类 号：R714.3[医药卫生—妇产科学]