潜伏期、活跃期行硬膜外与腰硬联合镇痛对产程及结局的影响  

Effects of epidural analgesia and combined spinal-epidural analgesia on course and outcome of labor in latent and active phases

作　　者：徐萍 汪林花 XU Ping;WANG Lin-hua(Shenzhen Far East Obstetrics and Gynecology Hospital,Shenzhen 518000,China)

机构地区：[1]深圳远东妇产医院,518000 [2]深圳市福田区妇幼保健院,518000

出　　处：《中国实用医药》2022年第9期45-48,共4页China Practical Medicine

摘　　要：目的分析潜伏期、活跃期行硬膜外与腰硬联合镇痛对产程及结局的影响。方法1173例初产妇,将其中326例潜伏期(宫口扩张<3 cm)行腰硬联合镇痛初产妇作为A组,673例活跃期(宫口扩张≥3 cm)行腰硬联合镇痛初产妇作为B组,174例活跃期行硬膜外镇痛作为C组。对比三组转剖率、第一产程时间、助产率。结果A组转剖率21.17%(69/326)高于B组的7.73%(52/673)、C组的13.79%(24/174),差异具有统计学意义(P<0.05);B组转剖率低于C组,差异具有统计学意义(P<0.05)。A组第一产程时间(11.83±3.41)h长于B组的(10.16±2.37)h、C组的(10.33±2.05)h,差异具有统计学意义(P<0.05);B组和C组第一产程时间对比差异无统计学意义(P>0.05)。三组助产率对比差异无统计学意义(P>0.05)。结论潜伏期行腰硬联合镇痛会明显延长产程时间,增加转剖率。Objective To analyze the effects of epidural analgesia and combined spinal epidural analgesia on course and outcome of labor in latent and active phases.Methods Among 1173 primiparas,326 primiparas who received combined spinal-epidural analgesia during the latent phase(cervical dilation<3 cm)were selected as group A,673 primiparas who received combined spinal-epidural analgesia in active phase(cervix dilation≥3 cm)were selected as group B,and 174 cases who received epidural analgesia in active phase were selected as group C.The conversion rate,the duration of the first stage of labor,and the midwifery rate were compared among the three groups.Results The conversion rate 21.17%(69/326)of group A was higher than 7.73%(52/673)of group B and 13.79%(24/174)of group C,and the difference was statistically significant(P<0.05).The conversion rate of group B was lower than that of group C,and the difference was statistically significant(P<0.05).The duration of the first stage of labor(11.83±3.41)h in group A was longer than(10.16±2.37)h in group B and(10.33±2.05)h in group C,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the time of the first stage of labor between group B and group C(P>0.05).There was no statistically significant difference in the midwifery rate among the three groups(P>0.05).Conclusion Combined spinal-epidural analgesia in latent phase will significantly prolong the course of labor and increase the rate of conversion rate.

关 键 词：硬膜外麻醉 腰硬联合麻醉 分娩镇痛 潜伏期 活跃期 产程 结局 

分 类 号：R714.3[医药卫生—妇产科学]