硬膜外阻滞分娩镇痛介入时机对产程时间的影响  

Effect of epidural analgesia initiation time-points on labor durations

作　　者：杨博 宋士斌 Yang Bo;Song Shibin(Department of Obstetrics and Gynecology,Sijing Hospital of Songjiang District,Shanghai 201601,China)

机构地区：[1]上海市松江区泗泾医院妇产科,201601 [2]上海市松江区泗泾医院麻醉科,201601

出　　处：《山西医药杂志》2023年第10期723-726,共4页Shanxi Medical Journal

基　　金：上海市松江区科技攻关项目(21SJKJGG65)。

摘　　要：目的探讨硬膜外阻滞分娩镇痛介入时机与产程时间的关系,并分析产程时间的影响因素。方法回顾性收集2019年2月至2021年12月在上海市松江区泗泾医院收治的231例行硬膜外阻滞分娩镇痛产妇的一般临床资料和产程时间,根据介入时机分为A组(宫口扩张<3 cm)和B组(宫口扩张≥3 cm),比较2组的临床特征和产程时间,采用一般线性回归分析产程时间的影响因素。结果A组初产妇的第一产程时间[300(195,461)min与420(270,540)min,Z=-2.29,P=0.022)]和总产程时间[355(246,496)min与500(340,615)min,Z=-2.21,P=0.027)]比B组的短。产次与全部产程时间均呈负相关(P<0.05),而麻醉时宫口扩张程度与第一产程时间呈正相关(R2=0.097,P<0.05)。结论对于单胎、足月、头位且产科评估可行阴道试产的初产妇,宫口扩张小于3 cm时介入硬膜外阻滞分娩镇痛可缩短第一产程时间,且不影响新生儿Apgar评分。Objective To investigate the relationship between epidural analgesia initiation time points and labor durations,and analyze the influencing factors of labor durations.Methods The general clinical data and labor durations of 231 pregnant women treated with epidural analgesia when delivering babies in Sijing Hospital,Songjiang District,Shanghai,from February 2019 to December 2021 were retrospectively collected.According to the initiation time points,these women were divided into groups A(the cervical dilation was<3 cm)and B(the cervical dilation was≥3 cm).The clinical features and labor durations of the two groups were compared,and the general linear regression to analyze the influence factors of labor durations was applied.Results The primiparas′duration of the first stage of labor[300(195,461)min vs 420(270,540)min,Z=-2.29,P=0.022)]and the total labor duration[355(246,496)min vs 500(340,615)min,Z=-2.21,P=0.027)]in group A were shorter than those in the group B(P<0.05).The parity was negatively correlated with the durations of labor(P<0.05),while the cervical dilation starting analgesia was positively correlated with the first labor duration(R2=0.097,P<0.05).Conclusion For single,full-term,cephalic primiparas with the feasible vaginal trial in obstetric evaluation,epidural analgesia initiated when the cervical dilation was less than 3 cm can shorten the duration of the first stage of labor,without affecting the delivery mode or neonatal Apgar scores.

关 键 词：分娩疼痛 硬膜外阻滞 分娩 产道 

分 类 号：R714.3[医药卫生—妇产科学]