双管法PCEA对胎位不正初产妇分娩结局的影响  

Effect of double-catheter PCEA on delivery outcomes in primiparae with malposition

作　　者：盛芝敏 杨月琴 滕永军 SHENG Zhi-min;YANG Yue-qin;TENG Yong-jun(Wenling Women＇s ＆ Children＇s Hospital, Zhejiang Wenling 317500, China)

机构地区：[1]浙江省温岭市妇幼保健院,浙江温岭317500

出　　处：《中国妇幼健康研究》2018年第4期507-510,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析双管法硬膜外镇痛分娩(PCEA)对胎位不正初产妇不同产程时间、胎位转复分娩及中转剖宫产发生的影响。方法选取2015年1月至2017年6月,浙江省温岭市妇幼保健院851例胎位不正的单胎足月初产妇作为研究对象。根据镇痛方法的不同,将其中414例行单管法PCEA分为单管组,437例行双管法PCEA分为双管组。比较两组初产妇产程时间、胎位转复分娩及中转剖宫产率的差异。结果双管组第一、二产程时间较单管组显著缩短(t值分别为3.06、4.14,均P<0.05);而两组初产妇第三产程时间比较无显著性差异(t=0.25,P>0.05)。双管组胎位转复分娩率(62.01%)较单管组(78.50%)明显降低(χ~2=4.24,P<0.05);双管组中转剖宫产率(17.16%)较单管组(30.92%)亦明显降低(χ~2=5.02,P<0.05)。结论双管法PCEA可明显缩短胎位不正初产妇的产程时间,降低胎位转复分娩率及中转剖宫产率,有利于改善分娩结局,具有良好的临床应用价值。Objective To analyze the effect of double-catheter patient-controlled epidural analgesia （PCEA） on different labor time, fetal position conversion, and cesarean section transferring in primipara with malposition. Methods A total of 851 full-term primiparae with malpositional single fetus in Wenling Women＇ s ＆ Children＇ s Hospital during January 2015 to June 2017 were selected as research objects. According to the different methods of analgesia, there were 414 cases accepting single-catheter PCEA as single-catheter group, while 437 eases accepting double-catheter PCEA as double-catheter group. The differences in labor time, fetal position conversion and cesarean section transferring between two groups were compared. Results The first and second stage of labor in the double-catheter group were significantly shorter than those of the single-catheter group （t value was 3.06 and 4.14, respectively, both P〈0.05）, but there was no significant difference in the third labor stage between two groups （t = 0.25, P 〉0.05）. The conversion rate of the fetal position in the double-catheter group （62.01%） was significantly lower than that in the single-catheter group （78. 50%） （χ^2 = 4.24, P 〈 0.05）. The rate of cesarean section transferring in the double-catheter group （17.16%） was also significantly lower than that in the single-catheter group （30.92%） （χ^2 = 5.02, P〈0.05）. Conclusion The double-catheter PCEA can significantly shorten the birth time of primiparae with malposition, reduce the rate of fetal position conversion and the rate of cesarean section transferring, which is beneficial to improve the outcome of delivery and is of good clinical application value.

关 键 词：双管法 硬膜外镇痛分娩 胎位不正 初产妇 剖宫产 

分 类 号：R719[医药卫生—妇产科学]