临产前与临产后实施硬膜外分娩镇痛对初产妇和新生儿的影响  

Effects of epidural labor analgesia before and after onset of labor on primiparous women and neonates

作　　者：王馨 靳茜茜 李佳慧[1] 刘心国[1] WANG Xin;JIN Xi-xi;LI Jia-hui;LIU Xin-guo(The Fifth People's Hospital of Ji'nan City,Ji'nan,Shandong 250022,China)

机构地区：[1]济南市第五人民医院,山东济南250022

出　　处：《中国妇幼保健》2023年第21期4077-4080,共4页Maternal and Child Health Care of China

基　　金：山东省济南市卫生健康委员会科技计划项目(2020-3-33)。

摘　　要：目的 分析并比较临产前与临产后实施硬膜外分娩镇痛对初产妇和新生儿的影响。方法 收集2019年1月—2021年3月在济南市第五人民医院实施硬膜外分娩镇痛的健康初产妇共407例,分为两组:A组(319例)为临产后实施麻醉的初产妇,B组(88例)为临产前实施麻醉的初产妇。将每例初产妇的年龄、身高、体质量、体质量指数、孕周、出血量、胎位、第一产程时间、第二产程时间、分娩结局、新生儿体质量及Apgar评分进行整理,并做数据分析。结果 两组初产妇第一产程时间比较差异具有统计学意义(P<0.05),A组第一产程时间[5.5(4.0,7.5)h]显著短于B组[6.5(5.0,8.0)h]。两组新生儿体质量比较差异具有统计学意义(t=-3.315,P<0.05),A组新生儿体质量显著低于B组。多因素logistic回归分析结果显示:第一产程时间对硬膜外分娩镇痛时机无显著影响,新生儿体质量是硬膜外分娩镇痛时机的独立影响因素(P<0.05)。结论 初产妇实施分娩镇痛的时机与新生儿体质量有关。新生儿体质量越大,初产妇分娩疼痛出现得越早,实施分娩镇痛越早。Objective To analyze and compare the effects of epidural labor analgesia before and after onset of labor on primiparous women and neonates.Methods From January 2019 to March 2021,407 healthy primiparous women receiving epidural labor analgesia in the Fifth People's Hospital of Ji'nan City were collected and divided into two groups,319 primiparous women in A group underwent epidural labor analgesia after onset of labor,and 88 primiparous women in B group underwent epidural labor analgesia before onset of labor.The data of primiparous women were collected,including age,height,weight,body mass index,gestational week,bleeding volume,fetal position,duration time of the first stage of labor,duration time of the second stage of labor,delivery outcome,neonatal weight,and Apgar score,then the results were analyzed.Results There was statistically significant difference in the duration time of the first stage of labor between the two groups(P<0.05),the duration time of the first stage of labor in A group[5.5(4.0,7.5)hours] was shorter than that in B group[6.5(5.0,8.0)hours].There was statistically significant difference in neonatal weight between the two groups(t=-3.315,P<0.05),neonatal weight in A group was lower than that in B group.Multivariate logistic regression analysis showed that the duration time of the first stage of labor had no significant impact on opportunity of epidural labor analgesia,neonatal weight was the independent influencing factor of opportunity of epidural labor analgesia(P<0.05).Conclusion The opportunity of epidural labor analgesia in primiparous women is related to neonatal weight.The larger neonatal weight is,the earlier labor pain appears,and the earlier labor analgesia implementation is.

关 键 词：硬膜外麻醉 分娩镇痛 初产妇 新生儿体质量 

分 类 号：R714.3[医药卫生—妇产科学]