分娩镇痛对初产妇产程及妊娠结局的影响  

The Effect of Intraspinal Labor Analgesia on Labor Process and Pregnancy Outcome

作　　者：汤思佳 刘照贞[1] 吴奕君 林晟[1] 陈寿珍 王晓梅[1] TANG Sijia;LIU Zhaozhen;WU Yijun;LIN Sheng;CHEN Shouzhen;WANG Xiaomei(Department of Obstetrics,Fujian Provincial Maternity and Children’s Hospital/Affiliated Hospital of Fujian Medical University,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院/福建医科大学附属医院产科,福建福州350001

出　　处：《中国卫生标准管理》2020年第21期57-60,共4页China Health Standard Management

摘　　要：目的探讨椎管内分娩镇痛对产程及妊娠结局的影响。方法选取福建省妇幼保健院2017年1月—12月椎管内分娩镇痛经阴道分娩初产妇53例为观察组,随机抽取同期经阴道分娩非镇痛初产妇55例为对照组,比较观察组与对照组产程及妊娠结局(产后2 h出血量、羊水胎粪污染率、新生儿科转入率、缩宫素使用率、阴道检查率和破膜方式)。结果观察组与对照组第一产程分别为7.33(4.50~13.75)h与13.00(10.00~15.00)h,第二产程分别为0.48(0.37~0.74)h与0.75(0.38~1.12)h,总产程分别为8.02(5.10~14.56)h与14.08(10.80~16.25)h,两组相比差异均有统计学意义(Z=-4.085,P<0.001;Z=-2.315,P=0.021;Z=-4.290,P<0.001;);观察组与对照组缩宫素使用率分别为22.6%(12/53)与54.5%(30/55),阴道检查率分别为26.4%(14/53)与58.2%(32/55),两组相比差异均有统计学意义(χ2=11.560,P=0.001;χ2=11.139,P=0.001);观察组第三产程时间、产后2 h出血量、羊水胎粪污染率、新生儿科转入率及人工破膜率与对照组相比,差异无统计学意义(P>0.05)。结论分娩镇痛能有效减轻疼痛,缩短第一、第二产程及总产程,安全可靠,可推广应用于产科分娩。Objective To explore the effect of intraspinal labor analgesia on labor process and pregnancy outcome.Methods 53 cases of primipara with intraspinal analgesia and vaginal delivery in Fujian Provincial Maternity and Children’s Hospital from January to December 2017 were selected as observation group,and 55 cases of non-analgesic primipara with vaginal delivery at the same time were randomly selected as control group.Comparing the labor process and pregnancy-related outcomes including postpartum 2-hour bleeding volume,meconium contamination rate of amniotic fluid,neonatal transfer rate,oxytocin use rate,vaginal examination rate and mode of rupture of membranes between the observation group and the control group.Results The first stage of labor in the observation group and the control group were 7.33(4.50~13.75)h and 13.00(10.00~15.00)h,respectively.The second stage was 0.48(0.37~0.74)h and 0.75(0.38~1.12)h,the total labor duration was 8.02(5.10~14.56)h and 14.08(10.80~16.25)h.There were significant differences between the two groups(Z=-4.085,P<0.001,Z=-2.315,P=0.021,Z=-4.290,P<0.001).The use rate of oxytocin in observation group and control group was 22.6%(12/53)and 54.5%(30/55),and the vaginal examination rate was 26.4%(14/53)and 58.2%(32/55),respectively.There were significant differences between the two groups(χ2=11.560,P=0.001,χ2=11.139,P=0.001).But there were no significant differences in the duration of the third stage of labor,the amounts of hemorrhage within 2 hours after delivery,the rate of meconium contamination in amniotic fluid,the rate of neonatal transfer and the rate of artificial rupture of membranes between two groups(P>0.05).Conclusion Labor analgesia can effectively relieve pain,shorten the first,second and total stages of labor,which is so safe and reliable that can be widely used in obstetric delivery.

关 键 词：椎管内分娩镇痛 初产妇 产程 产科干预 妊娠结局 产后出血 人工破膜 

分 类 号：R714[医药卫生—妇产科学]