不同麻醉方式分娩镇痛对产程及母婴结局的影响  

Effects of Different Anesthesia Methods on the Labor Analgesia and Outcomes of Maternal and Infant

作　　者：蒋延安 付华君 赵静[1] 孟娟 朱利娟 JIANG Yan-an;FU Hua-jun;ZHAO Jing;MENG Juan;ZHU Li-juan(Anesthesiology Department,Shaanxi People's Hospital,Xi'an,Shaanxi,710068,China;Endoscopy room,Shaanxi People's Hospital,Xi'an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068 [2]陕西省人民医院内镜室,陕西西安710068

出　　处：《现代生物医学进展》2020年第9期1737-1740,共4页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(S2017-ZDYF-YBXM-0615)。

摘　　要：目的:探讨不同麻醉方式分娩镇痛对产程及母婴结局的影响。方法:选取2016年7月至2018年7月我院收治的154例分娩镇痛产妇为研究对象,根据随机抽签原则将受试者进行分组,对照组77例产妇接受常规的静脉麻醉镇痛,研究组77例产妇接受硬膜外麻醉镇痛,比较两组产妇的产程时间、疼痛分级、母婴结局及24h泌乳情况。结果:研究组产妇的产程时间显著短于对照组(P<0.05),0级及Ⅰ级疼痛的比率显著低于对照组(P<0.05),Ⅱ级及Ⅲ级疼痛的比率显著高于对照组(P<0.05),产妇阴道助产、中转剖宫产、尿潴留及产后出血量均显著少于对照组(P<0.05),新生儿宫内窘迫及窒息的发生率显著低于对照组(P<0.05)。两组新生儿出生后1 min、5 min及10 min的Apgar评分比较无统计学差异(P>0.05),研究组产妇产后24h有效泌乳率显著高于对照组(P<0.05)。结论:硬膜外麻醉镇痛可有效缩短产程时间,减轻疼痛,改善母婴结局,促进产后泌乳。Objective:To explore the effect of different anesthesia methods on the labor analgesia and outcomes of maternal and child.Methods:154 maternity with labor analgesia from July 2016 to July 2018 were selected as the subjects.According to the principle of random lottery,the maternity were divided into the control group and study group with 77 cases in each group.The control group was given conventional intravenous anesthesia for analgesia,while the study group maternity was given anesthesia for analgesia.The maternal labor time,pain grading,maternal and infant outcomes and maternal 24h lactation were compared between the two groups.Results:The maternal labor time of study group were significantly shorter than that of the control group(P<0.05).The rate of pain in grade 0 and grade I of the study group was significantly lower than that of the control group.The ratio of grade II and grade III pain was significantly higher than that of the control group(P<0.05).The vaginal midwifery,transit cesarean section,urinary retention and postpartum hemorrhage in the study group were significantly lower than those in the control group(P<0.05).The incidence of intrauterine distress and asphyxia in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in the Apgar scores between the two groups at 1 minute and 10 minutes after birth(P>0.05).The effective lactation rate of study group was significantly higher than that of the control group at 24 hours postpartum(P<0.05).Conclusion:Epidural anesthesia can effectively shorten the time of labor,reduce pain,improve maternal and infant outcomes,promote the postpartum lactation.

关 键 词：分娩镇痛 静脉麻醉 硬膜外麻醉 产程时间 疼痛分级 母婴结局 24h泌乳量 

分 类 号：R714.3[医药卫生—妇产科学] R614[医药卫生—临床医学]