腰硬联合麻醉分娩镇痛后发热对母婴分娩结局的影响  

Influence of fever after delivery analgesia under combined spinal-epidural anesthesia on the delivery outcomes of both mothers and infants

作　　者：刘伟武[1] 曾伟兰[1] 徐敏兰[1] 徐秀英[1] 周树强[2] 梁妙 LIU Weiwu;ZENG Weilan;XU Minlan;XU Xiuying;ZHOU Shuqiang;LIANG Miao(Department of Obstetrics,Yulin Maternal and Child Health Center,Yulin 537000,Guangxi,China;Department of Anesthesiology,Yulin Maternal and Child Health Center,Yulin 537000,Guangxi,China)

机构地区：[1]广西玉林市妇幼保健院产科,广西玉林537000 [2]广西玉林市妇幼保健院麻醉科,广西玉林537000

出　　处：《右江医学》2024年第6期518-522,共5页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区医疗卫生重点(培育)学科(桂卫科教发〔2022〕4号);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210920)。

摘　　要：目的探讨腰硬联合麻醉分娩镇痛后发热对分娩结局的影响,以期改善母婴结局。方法选取2020年1月至2022年6月进行腰硬联合麻醉分娩镇痛的300例产妇作为研究对象,根据镇痛后是否出现发热将产妇分为两组。对照组为未出现发热的产妇,共150例;观察组为出现发热的产妇,共150例。比较两组产妇的阴道操作次数、破膜时间、总产程时间、缩宫素使用比例、分娩方式、产妇不良结局发生率以及新生儿不良结局发生率。结果观察组阴道操作次数(7.56±1.12)次,破膜时间为(11.86±2.03)h,总产程时间为(17.08±2.34)h,使用缩宫素加强宫缩为51例(34.00%),对照组阴道操作次数(5.41±1.04)次,破膜时间为(8.69±1.75)h,总产程时间为(15.04±1.84)h,使用缩宫素加强宫缩为20例(13.33%),两组产妇的阴道操作次数、破膜时间、总产程时间、缩宫素使用比例等指标比较差异均有统计学意义(P<0.001)。观察组产妇自然分娩82例(54.67%),剖宫产45例(30.00%),器械助产23例(15.33%),对照组产妇自然分娩121例(80.67%),剖宫产19例(12.67%),器械助产10例(6.67%),两组产妇的分娩方式比较差异有统计学意义(P<0.05或0.001)。观察组产妇出现低血压、头痛、产后出血、产褥感染等总不良结局发生率为60.67%(91/150),对照组产妇出现低血压、头痛、产后出血、产褥感染等总不良结局发生率为31.33%(47/150),两组产妇总不良结局发生率差异有统计学意义(P<0.001)。观察组出现胎儿窘迫、新生儿窒息、新生儿败血症、新生儿高胆红素血症等总不良结局发生率为40.67%(61/150),对照组出现胎儿窘迫、新生儿窒息、新生儿败血症、新生儿高胆红素血症等总不良结局发生率为22.67%(34/150),两组新生儿总不良结局发生率差异有统计学意义(P<0.001)。结论产时发热是一种临床表现,早发现早预防非常重要。对于产科医生而言,应加强产程管理,掌握阴道操作指征,�Objective To explore the effect of fever after delivery analgesia with combined spinal-epidural anesthesia on delivery outcomes,so as to improve the outcomes of both mothers and infants.Methods A total of 300 parturients who underwent combined spinal-epidural anesthesia during labor analgesia in hospital from January 2020 to June 2022 were selected as research objects.150 parturients who did not experience fever were selected as control group,and 150 parturients who experienced fever were selected as observation group.And then,number of vaginal procedures,time of membrane rupture,total duration of labor,proportion of oxytocin use,mode of delivery,incidence of maternal adverse outcomes,and incidence of adverse neonatal outcomes between the two groups were compared.Results The number of vaginal procedures in the observation group was(7.56±1.12)times,the time of membrane rupture was(11.86±2.03)hours,the total duration of labor was(17.08±2.34)hours,and 51 cases(34.00%)required the use of oxytocin to enhance uterine contractions,while the number of vaginal procedures in the control group was(5.41±1.04)times,the time of membrane rupture was(8.69±1.75)hours,the total duration of labor was(15.04±1.84)hours,and 20 cases(13.33%)required the use of oxytocin to enhance uterine contractions,so differences in the comparison of indexes such as number of vaginal procedures,time of membrane rupture,total duration of labor,proportion of oxytocin use were all statistically significant(P<0.001).There were 82 cases(54.67%)of spontaneous vaginal delivery,45 cases(30.00%)of cesarean section,and 23 cases(15.33%)of assisted delivery with instruments in the observation group,there were 121 cases(80.67%)of spontaneous vaginal delivery,19 cases(12.67%)of cesarean section,and 10 cases(6.67%)of assisted delivery with instruments in the control group,and difference of comparison of delivery methods between the two groups was statistically significant(P<0.05 or 0.001).The total incidence of adverse outcomes such as hypotension,headache,po

关 键 词：腰硬联合麻醉 分娩镇痛 产妇 发热 分娩方式 母婴结局 

分 类 号：R714.3[医药卫生—妇产科学]