硬膜外分娩镇痛期间产时发热的相关因素  

Relevant factors of maternal intrapartum fever during epidural labor analgesia

作　　者：刘叶 李红[1] 刘枝 毛慧敏[1] 张瑾[1] 高义 李腾 LIU Ye;LI Hong;LIU Zhi;MAO Huimin;ZHANG Jin;GAO Yi;LI Teng(Department of Anesthesiology,the Fourth Hospital of Shijiazhuang City,Obstetrics and Gynecology Hospital Affiliated to Hebei Medical Univercity,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第四医院(河北医科大学附属妇产医院)麻醉科,050000

出　　处：《临床麻醉学杂志》2022年第1期57-60,共4页Journal of Clinical Anesthesiology

摘　　要：目的分析硬膜外分娩镇痛期间产妇发热的相关因素。方法回顾性分析2019年6—12月产房待产自愿要求硬膜外分娩镇痛产妇170例,ASAⅠ或Ⅱ级,孕期37~40周。根据体温是否≥38℃分为两组:发热组和非发热组。记录产程、胎膜破裂至分娩结束时间、阴道检查次数、分娩镇痛时间及硬膜外镇痛给药方式等,采用Logistic回归法分析硬膜外分娩镇痛期间产时发热的相关因素。结果共有58例(34.1%)产妇出现产时发热。与非发热组比较,发热组产妇BMI明显增大,初产妇、产前抑郁、产前焦虑、使用缩宫素、羊水污染、连续给药比例明显升高(P<0.05);产程时间、胎膜破裂至分娩结束时间及分娩镇痛时间明显延长(P<0.05);阴道检查次数明显增多(P<0.05)。多因素Logistic回归分析结果显示,BMI(>28.5 kg/m^(2),OR=2.227,95%CI 1.035~2.426)、使用缩宫素(OR=2.062,95%CI 1.637~2.858)、阴道检查次数(>9次,OR=1.484,95%CI 1.136~3.144)、产程时间(>9.3 h,OR=1.014,95%CI 1.009~1.045)、胎膜破裂至分娩结束时间(>4.7 h,OR=1.002,95%CI 1.002~1.013)、分娩镇痛时间(>5.3 h,OR=1.214,95%CI 1.042~1.823)、硬膜外镇痛间断给药(>5.3 h,OR=1.311,95%CI 1.214~3.332)与硬膜外分娩镇痛期间产时发热相关。结论BMI、使用缩宫素、阴道检查次数、产程时间、胎膜破裂至分娩结束时间、分娩镇痛时间及硬膜外镇痛给药方式均是硬膜外分娩镇痛期间产时发热的相关因素。Objective To analyze the related factors of maternal intrapartum fever during epidural labor analgesia.Methods A retrospective analysis was performed on 170 cases of puerperae who voluntarily request epidural analgesia for delivery in the delivery room,ASA physical statusⅠorⅡ,37-40 weeks of pregnancy,from June to December 2019.They were divided into two groups:fever group and non-fever group according to whether the body temperature was≥38℃.The labor process,the time from rupture of the fetal membranes to the end of labor,the number of vaginal examinations,the time of labor analgesia,and the way of administration of epidural analgesia were recorded.Logistic regression method was used to analyze the related factors of intrapartum fever during epidural labor analgesia.Results Fifty-eight puerpera(34.1%)showed intrapartum fever.Compared with the non-fever group,the proportion of maternal BMI,primipara,prenatal depression,antenatal anxiety,use of oxytocin,amniotic fluid pollution,and continuous administration in the fever group was significantly increased(P<0.05);the time of labor,the time from rupture of fetal membranes to the end of labor,and the time of labor analgesia were significantly prolonged(P<0.05).The frequency of vaginal examination was significantly increased in the fever group compared with the control group(P<0.05).The results of multivariate logistic regression analysis showed that BMI(>28.5 kg/m^(2),OR=2.227,95%CI 1.035-2.426),use of oxytocin(OR=2.062,95%CI 1.637-2.858),vaginal examinations(>9 times,OR=1.484,95%CI 1.136-3.144),labor time(>9.3 h,OR=1.014,95%CI 1.009-1.045),time from membrane rupture to the end of delivery(>4.7 h,OR=1.002,95%CI 1.002-1.013),labor analgesia time(>5.3 h,OR=1.214,95%CI 1.042-1.823),intermittent epidural analgesia(OR=1.311,95%CI 1.214-3.332)were related with intrapartum fever during epidural labor analgesia.Conclusion BMI,use of oxytocin,the number of vaginal examinations,labor time,time from rupture of fetal membranes to the end of labor,labor analgesia time,and e

关 键 词：硬膜外麻醉 回归分析 产时发热 分娩镇痛 

分 类 号：R714.3[医药卫生—妇产科学]