硬膜外阻滞分娩镇痛对母婴影响的回顾性研究  

A Retrospective Study of Effect of Epidural Analgesia on Parturients and Neonates

作　　者：李彬 方建军 王婷婷 LI Bin;FANG Jian-jun;WANG Ting-ting(Changning Maternity and Infant Health Hospital,Shanghai,200050,China)

机构地区：[1]上海市长宁区妇幼保健院,上海200050

出　　处：《中国初级卫生保健》2022年第12期109-112,共4页Chinese Primary Health Care

摘　　要：目的:分析硬膜外阻滞分娩镇痛对产妇和新生儿的影响,为硬膜外阻滞分娩镇痛在临床上的应用提供参考依据。方法:回顾性分析2018年5月—2019年12月上海市长宁区妇幼保健院所有足月单胎顺产分娩产妇的产程记录。依据有无进行硬膜外阻滞分娩镇痛将产妇分成分娩镇痛组和未镇痛组。对两组产妇总产程时间、产后2小时出血量、第三产程失血量、产后15 min产妇的生命体征,以及新生儿Apgar评分和脐静脉血气分析结果进行分析比较。结果:分娩镇痛组产妇总产程时间为(457.72±200.36)min,未镇痛组产妇总产程时间为(366.82±201.15)min,两组比较,差异有统计学意义(t=2.26,P<0.05)。分娩镇痛组新生儿出生后1 min和5 min的Apgar评分分别为(8.96±0.12)分和(9.67±0.08)分,未镇痛组新生儿分别为(8.97±0.13)分和(9.64±0.10)分,两组比较,差异均无统计学意义(P>0.05)。新生儿脐静脉血气分析结果显示,分娩镇痛组新生儿碱剩余量和标准碱剩余量与未镇痛组新生儿比较,差异均有统计学意义(t值分别为2.16和2.19,P值均<0.05);分娩镇痛组新生儿碳酸氢根离子实测浓度和标准浓度、血二氧化碳总含量、血氧含量均高于未镇痛组新生儿,差异均有统计学意义(t值分别为3.13、3.03、2.26和3.00,P值均<0.05);分娩镇痛组新生儿二氧化碳分压低于未镇痛组新生儿,差异有统计学意义(t=2.52,P<0.05)。结论:硬膜外阻滞分娩镇痛与产妇总产程延长具有相关性,硬膜外阻滞分娩镇痛对新生儿是安全的。OBJECTIVE To evaluate the effect of epidural labor analgesia on parturients and neonates,to provide a reference basis for the clinical application of epidural block and labor analgesia.METHODS It reviewed the medical records of vaginal delivery and neonatal data of full-term parturients with singleton pregnancy form May 2018 to December 2019.Parturients were divided into non-labor analgesia group and labor analgesia group according to whether or not labor analgesia was performed.The total time of labor,the amount of blood loss in the third stage of labor,the amount of blood loss in the second hour after delivery,the vital signs of the parturients 15 minutes after delivery,the Apgar score of the neonatus and the PH value of blood gas in umbilical vein were statistically analyzed.RESULTS The total labor time in the labor analgesia group was(457.72±200.36)min,and the total duration of labor in the analgesic group was(366.82±201.15)min,and the two groups were statistically significant(t=2.26,P<0.05).The Apgar scores of 1 min and 5 min after birth in the labor analgesia group were the(8.96±0.12)and(9.67±0.08)scores,respectively.Neonates in the non-analgesia group were(8.97±0.13)and(9.64±0.10),respectively.Neither the two groups was statistically significant(P>0.05).The results of neonatal umbilical vein blood gas analysis showed that the neonatal alkali surplus and standard alkali surplus were significant compared with the unanalgesic group(t=2.16,2.19,P<0.05).The measured concentration and standard concentration of bicarbonate ion,total blood carbon dioxide content and blood oxygen content of the neonates in the labor analgesia group were all higher than those in the unanalgesia group,and the difference was statistically significant(t=3.13,3.03,2.26,3.00,P<0.05).Carbon dioxide content was lower in the labor analgesia group than that in the unanalgesia group(t=2.52,P<0.05).CONCLUSION Epidural labor analgesia is associated with prolonging the total labor time strikingly Epidural labor analgesia is safe for neonat

关 键 词：硬膜外阻滞分娩镇痛 产妇 新生儿 回顾性研究 

分 类 号：R714.3[医药卫生—妇产科学]