椎管内分娩镇痛对剖宫产术后再次妊娠妇女阴道分娩结局的影响  

The effect of intra-spinal labor analgesia on the outcome of vaginal delivery in second-term pregnant women after cesarean section

作　　者：张秀华[1] 唐晓英[1] 刘先平[1] 周翠华 ZHANG Xiu-hua;TANG Xiao-ying;LIU Xian-ping;ZHOU Cui-hua(Department of Obstetrics,the Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospital,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院第二临床医学院,南充市中心医院产科,四川南充637000

出　　处：《川北医学院学报》2020年第2期340-342,共3页Journal of North Sichuan Medical College

基　　金：四川省南充市社科研究“十三五”规划(NC2018B032)。

摘　　要：目的:探讨椎管内麻醉镇痛对剖宫产术后再次妊娠妇女阴道分娩结局的影响。方法:回顾性分析150例剖宫产再孕产妇的临床资料,根据阴道试产过程中是否施行了椎管内分娩镇痛,将所有产妇分为镇痛组(n=92)和非镇痛组(n=58),分析两组产妇产程时间和阴道分娩成功率的差异。结果:镇痛组的第一产程时间(13.57±1.45)h、试产过程中因疼痛中转剖宫产率(10.87%)均低于非镇痛组,差异有统计学意义(P<0.05);两组新生儿Apgar评分、产时出血量比较,差异无统计学意义(P>0.05);两组先兆子宫破裂、胎儿窘迫发生率比较,差异无统计学意义(P>0.05)。结论:椎管内分娩镇痛能缩短剖宫产术后再次妊娠妇女阴道分娩第一产程时间,减少试产过程中因疼痛中转剖宫产数,从而降低再次剖宫产率。Objective:To investigate the effect of intra-spinal labor analgesia on the outcome of vaginal delivery after cesarean section.Methods:Retrospective analysis the clinical data of 150 cases of cesarean section and maternal,according to whether the vaginal trial production in the process of implementation of the spinal canal labor analgesia were divided into analgesia group(92 cases)and non analgesia(58 cases),analysis of of the difference between the two groups of maternal labor time and success rate of vaginal delivery.Results:The first stage of labor(13.57±1.45)h in the analgesia group and the conversion rate of cesarean section due to pain during the trial labor(10.87%)were lower than those in the non-analgesia group,with statistically significant differences(P<0.05).There was no significant difference in Apgar score,time of second labor and blood loss during labor between the two groups(P>0.05).The incidence of threatened uterine rupture and fetal distress in the two groups were no statistically significant(P>0.05).Conclusion:Intra-spinal labor analgesia can shorten the first stage of vaginal delivery after cesarean section,reduce the number of pain-induced cesarean delivery during the trial delivery,and reduce the rate of second cesarean delivery.

关 键 词：分娩镇痛 剖宫产再孕 阴道分娩 产程 母婴结局 

分 类 号：R714.3[医药卫生—妇产科学]