持续性硬膜外麻醉对第一产程影响的临床研究  

Clinical study on the effect of continuous epidural anesthesia on the first stage of labor

作　　者：谭育松[1] TAN Yu-Song(Changchun Obstetrics and Gynecology Hospital,Changchun,Jilin 130042,China)

机构地区：[1]长春市妇产医院,吉林长春130042

出　　处：《中国妇幼保健》2020年第17期3153-3155,共3页Maternal and Child Health Care of China

基　　金：吉林省卫生和计划生育委员会课题(2017J003)。

摘　　要：目的探讨持续性硬膜外麻醉对第一产程的进展、母儿情况的临床研究。方法对2018年1月-2019年12月在长春市妇产医院阴道分娩的200例产妇进行回顾性分析,观察持续性硬膜外麻醉镇痛分娩产妇(观察组)和无镇痛分娩产妇(对照组)第一产程活跃期进展、宫缩变化、应用缩宫素情况、胎儿宫内情况、转剖宫产及疼痛视觉模拟评分(VAS评分)。结果两组第一产程活跃期时间比较,差异有统计学意义(P<0.05),观察组活跃期时间明显多于对照组,两组产程缩宫素的应用比较,差异有统计学意义(P<0.05);胎儿电子胎心监护(EFM)出现Ⅱ类以上图形,两组比较差异有统计学意义(P<0.05);第一产程转剖宫分娩(活跃期停滞、胎心异常),观察组与对照组比较,差异无统计学意义(P>0.05)。观察组、对照组宫口开大3.0 cm后1 h宫缩压力、宫缩间隔时间、宫缩持续时间平均值比较,差异有统计学意义(P<0.05)。两组VAS评分比较,差异有统计学意义(P<0.05),实施硬膜外麻醉后,患者疼痛明显减轻。结论虽然持续性硬膜外麻醉在产程进展的过程中出现一些问题,但很好地解决了产程过程中出现的疼痛问题,因此需要我们在第一产程进展过程中,积极的管理产程,对阴道分娩成功有重要的临床意义。Objective To investigate the effect of continuous epidural anesthesia on the progress of the first stage of labor and the situation of mother and infant.Methods 200 cases of vaginal delivery in Changchun Obstetrics and Gynecology Hospital from January 2018 to December 2019 were retrospectively analyzed.The active phase progress,uterine contraction changes,oxytocin application,fetal intrauterine situation,cesarean section and VAS score were observed in the first stage of labor in patients with continuous epidural anesthesia analgesia(observation group)and non analgesia delivery patients(control group).Results In the first stage of labor,there was a significant difference between the observation group and the control group(P<0.05),which was statistically significant,and the observation group was significantly more than the control group;the application of oxytocin in the labor process was significantly different between the observation group and the control group(P<0.05);the fetal intrauterine situation,EFM(electronic fetal heart rate monitoring)showed more than classⅡgraphics,the observation group and the control group had The difference was statistically significant(P<0.05);Conversion of the first stage of labor to cesarean section(active phase stagnation,abnormal fetal heart rate),there was no significant difference between the observation group and the control group(P>0.05).There were significant differences between the observation group and the control group in the mean value of uterine contraction pressure,interval time and duration of uterine contraction 1 hour after the opening of uterine orifice 3.0 cm(P<0.05).There was significant difference in VAS score between the observation group and the control group(P<0.05).Conclusion Although there are some problems in the process of labor process,continuous epidural anesthesia can solve the problem of pain in the process of labor.Therefore,we need to actively manage the labor process in the process of the first stage of labor,which is of great significance for t

关 键 词：持续性硬膜外麻醉 第一产程 活跃期 剖宫产率 

分 类 号：R714.3[医药卫生—妇产科学]