硬膜外分娩镇痛在瘢痕子宫再次妊娠患者阴道试产中的临床应用价值  

Clinical application value of epidural labor analgesia in vaginal trial production of patients with subsequent pregnancy after cesarean section

作　　者：周丹 卢海英[1] 王正坤[1] 冯小红[1] 刘玮 ZHOU Dan;LU Hai-Ying;WANG Zheng-Kun(Maternity Center,Foshan Municipal Maternal and Child Health Care Hospital,Foshan,Guangdong 528000,China)

机构地区：[1]佛山市妇幼保健院妇产中心

出　　处：《中国妇幼保健》2019年第23期5345-5347,共3页Maternal and Child Health Care of China

基　　金：佛山市卫生和计生局医学科研课题项目(20170124)

摘　　要：目的探讨硬膜外分娩镇痛在瘢痕子宫再次妊娠患者阴道试产中的临床应用价值,为临床提供参考依据。方法选择佛山市妇幼保健院2016年1月1日-2018年10月1日收治的200例瘢痕子宫再次妊娠患者;采用随机数字表法分组,对照组(100例):正常完成阴道试产;观察组(100例):选择硬膜外分娩镇痛方式完成阴道试产;就两组再次妊娠患者分娩时间、试产成功率、新生儿Apgar评分以及产后出血对比。结果同对照组患者分娩时间对比,观察组第二产程时间明显缩短,差异有统计学意义(P<0.05),第三产程时间差异无统计学意义(P>0.05);同对照组患者试产成功率(82.00%)对比,观察组(97.00%)获得明显提升,差异有统计学意义(P<0.05);两组患者新生儿Apgar评分及产后出血对比,差异无统计学意义(均P>0.05)。结论瘢痕子宫再次妊娠患者在阴道试产期间,麻醉医师选择硬膜外分娩镇痛方式进行干预,对缩短患者第二产程时间以及提升试产成功率发挥显著作用,充分证明硬膜外分娩镇痛方式具有很高的临床应用价值。Objective To explore the clinical application value of epidural labor analgesia in vaginal trial production of patients with subsequent pregnancy after cesarean section,provide a reference basis for clinical treatment.Methods A total of 200 patients with subsequent pregnancy after cesarean section treated in Foshan Municipal Maternal and Child Health Care Hospital from January 1 st,2016 to October 1 st,2018 were selected and divided into two groups according to random number table,100 patients in each group.The patients in control group were treated by normal vaginal trial production,and the patients in observation group were treated by vaginal trial production based on epidural labor analgesia.The delivery time,successful rates of vaginal trial production,neonatal Apgar scores,and the incidence rates of postpartum hemorrhage in the two groups were compared.Results The time of the second stage of labor in observation group was statistically significantly shorter than that in control group(P<0.05),there was no statistically significant difference in the time of the third stage of labor between the two groups(P>0.05).The successful rate of vaginal trial production in observation group was 97.00%,which was statistically significantly higher than that in control group(82.00%)(P<0.05).There was no statistically significant difference in Apgar score and incidence rate of postpartum hemorrhage between the two groups(P>0.05).Conclusion During vaginal trial production of patients with subsequent pregnancy after cesarean section,epidural labor analgesia can shorten the time of the second stage of labor and improve the successful rate of vaginal trial production,which has high cinical application value.

关 键 词：硬膜外分娩镇痛 瘢痕子宫 再次妊娠 阴道试产 临床应用价值 

分 类 号：R714[医药卫生—妇产科学]