潜伏期椎管内镇痛增加肥胖初产妇的中转剖宫产率的影响  

Effect of Latent Intraspinal Analgesia on Conversion to Cesarean Section Rate of Obese Primiparas

作　　者：刘彦楠 施蓉 蒋月明 李维维 LIU Yannan;SHI Rong;JIANG Yueming;LI Weiwei(Department of Anesthesia,Xuzhou City Maternal and Child Health Hospital,Xuzhou,Jiangsu 221000)

机构地区：[1]徐州市妇幼保健院麻醉科,江苏徐州221000

出　　处：《智慧健康》2023年第23期167-170,179,共5页Smart Healthcare

摘　　要：目的探讨在潜伏期或活跃期开始实施椎管内镇痛对肥胖初产妇中转剖宫产率的影响。方法选取2019年1月1日—2021年12月31日在徐州市妇幼保健院产科实施椎管内无痛分娩的肥胖(体重指数≥30kg/m2)初产妇835例为研究对象。按照椎管内镇痛宫口大小分为潜伏期镇痛组(n=521,宫口开放≤3cm)、活跃期镇痛组(n=314,宫口开放>3cm),通过回归分析肥胖初产妇主次要结局。结果在肥胖初产妇中,潜伏期镇痛组的中转剖宫产率显著高于活跃期镇痛组(P<0.05);倾向性匹配后的Logistic回归提示潜伏期椎管内镇痛是肥胖初产妇中转剖宫产的独立危险因素(P=0.001);潜伏期镇痛组的第一产程时间更长(P<0.001)。结论潜伏期椎管内镇痛增加肥胖初产妇的中转剖宫产率,增加了第一产程时间。Objective To investigate effect of intraspinal analgesia in latent or active period on conversion rate of obese primipara to cesarean section.Methods The paper reviewed and studied 835 obese primiparas(body mass index≥30 kg/m2)delivered painlessly in spinal canal in obstetrics department of Xuzhou City Maternal and Child Health Hospital from January 1,2019 to December 31,2021,and divided them into latency analgesia group(n=521,with uterine opening≤3cm)and active analgesia group(n=314,with uterine opening>3cm)According to size of intraspinal analgesia uterine opening.Primary and secondary outcomes of obese primiparous women were analyzed through regression analysis.Results Among obese primipara,conversion rate to cesarean section in latency analgesia group was significantly higher than active analgesia group(30.9%vs 22.9%).Logistic regression after propensity matching suggested that latency intraspinal analgesia was an independent risk factor for conversion of obese primipara to caesarean section(P=0.001).Meanwhile,latency analgesia group had longer first stage of labor(P<0.001).Conclusion Latent intraspinal analgesia can increase conversion rate of obese primipara to cesarean section,and increase first stage time of labor.

关 键 词：椎管内镇痛 分娩 剖宫产 肥胖产妇 

分 类 号：R714.3[医药卫生—妇产科学]