高原地区初产妇硬膜外镇痛分娩不同介入时机的选择  

The choice between different timing of epidural analgesia for labor in primiparas from high-land area

作　　者：徐建国[1] 郝丽芸 黄华[2] 陈雯 柴能珍 Xu Jianguo;Hao Liyun;Huang Hua;Chen Wen;Chai Nengzhen(Department of Gynaecology and Obstetrics,General Hospatal of Tibet Military,850009,Area,Lasha China)

机构地区：[1]西藏军区总医院妇产科,西藏拉萨850009 [2]西藏军区总医院麻醉科,西藏拉萨850009

出　　处：《西藏医药》2023年第1期35-37,共3页Tibetan Medicine

摘　　要：目的比较高原地区产程潜伏期与活跃期分别实施硬膜外镇痛分娩的有效性、安全性和对新生儿的影响。方法选择临产后实施硬膜外镇痛分娩的初产妇120例,按照实施硬膜外镇痛的时机随机分为观察组(潜伏期组,宫口扩张<3cm)和对照组(活跃期组,宫口扩张≥3cm),比较二组疼痛评分(VAS)、第一产程、第二产程时间、助产比例以及新生儿第1、5min时的Apgar评分。结果观察组产程中VAS评分明显低于对照组,观察组第一产程时间短于对照组,差异有统计学意义(P<0.05)。两组间产妇第二产程时间、助产率和新生儿第1、5min时Apgar评分比较差异无统计学意义(P>0.05)。结论高原地区硬膜外镇痛分娩始于产程潜伏期和活跃期对母婴均安全,而潜伏期镇痛可以尽早减轻产妇痛苦,缩短第一产程,值得推广。Objective To compare the efficacy and safety of epidural analgesia between the incubation and activation period.Me t hods120 primiparas who choose the epidural analgesia were randomly selected and divided into observation group(incubation group;n=60,dilation of cervix<3cm)and control group(activation group;n=60,dilation of cervix≥3cm).The Visual Analogue Scale(VAS),the time of the first~stage and second~stage of labor,ratio of assistant labor and the Apgar score of neonatal at the first and fifth minute were recorded.ResultS There were a statistical reduced VAS,a shorter first~stage of labor in the observation group compared with the control group(P<0.05).There were no statistical significance changes among the second~stage of labor,ratio of assistant labor and the Apgar score of neonatal at the first and fifth minute(P>0.05).Conclusions It is safe for the mother and fetus in high~land area whenever the epidural analgesia begins at the incubation period or activation period.Epidural analgesia in the incubation period can be as early as possible to reduce maternal pain and shorten the time of the first~stage of labor,which is worth to popularize.

关 键 词：硬膜外镇痛分娩 潜伏期 活跃期 新生儿Apgar评分 高原 

分 类 号：R714.3[医药卫生—妇产科学]