硬膜外分娩镇痛在剖宫产后阴道分娩产妇中的应用效果分析  

Effect of Epidural Labor Analgesia on Vaginal Delivery after Cesarean Section

作　　者：夏李林 黄蓉 彭静[1] 祁文瑾[2] Xia Lilin;Huang Rong;Peng Jing;Qi Wenjin(Department of Obstetrics,Kunming First People's Hospital,Kunming 650000,Yunnan Province,China;Department of Obstetrics,the First Affiliated Hospital of Kunming Medical University,Kunming 650000,Yunnan Province,China)

机构地区：[1]昆明市第一人民医院产科,云南昆明650000 [2]昆明医科大学第一附属医院产科,云南昆明650000

出　　处：《中国社区医师》2024年第25期49-51,共3页Chinese Community Doctors

摘　　要：目的:探讨硬膜外分娩镇痛在剖宫产后阴道分娩(VBAC)产妇中的应用效果。方法:选取2019年4月—2023年4月于昆明医科大学第一附属医院产科住院分娩的145例VBAC产妇作为研究对象,随机分为观察组(n=68)和对照组(n=77)。对照组实施常规自然分娩,观察组实施硬膜外分娩镇痛。比较两组疼痛程度、并发症发生情况、新生儿情况。结果:宫口开4~5 cm、宫口开6~7 cm、宫口开全,对照组疼痛评分逐渐升高,且观察组疼痛评分低于对照组(P<0.05)。观察组产时发热率高于对照组(P<0.05)。观察组脐静脉碱剩余量高于对照组,脐静脉乳酸水平低于对照组(P<0.05)。结论:硬膜外分娩镇痛在VBAC产妇中的应用效果显著,可减轻产妇疼痛,预防无氧酵解导致的代谢性酸中毒,虽然产时发热率较高但对妊娠结局无不良影响。Objective:To investigate the effect of epidural labor analgesia in women who delivered vaginally after cesarean section(VBAC).Methods:A total of one hundred and forty-five VBAC parturients who were hospitalized in the obstetrics department of the First Affiliated Hospital of Kunming Medical University from April 2019 to April 2023 were selected as the study objects,and randomly divided into observation group(n=68)and control group(n=77).The control group was given routine natural labor,and the observation group was given epidural labor analgesia.The degree of pain,complications and neonatal conditions were compared between the two groups.Results:The pain scores of the control group were gradually increased,and the pain scores of the observation group were lower than those of the control group(P<0.05),the opening of the uterine orifice was 4~5 cm,6~7 cm,and the opening of the uterine orifice was complete;the intrapartum fever rate of observation group was higher than that of control group(P<0.05);the remaining amount of umbilical vein alkali in observation group was higher than that in control group,and the level of umbilical vein lactic acid was lower than that in control group(P<0.05).Conclusion:Epidural labor analgesia has a significant effect in VBAC parturiency,which can reduce parturiency pain and prevent metabolic acidosis caused by anaerobic colysis.Although the fever rate during labor is high,it has no adverse effect on pregnancy outcome.

关 键 词：硬膜外分娩镇痛 剖宫产后阴道分娩 疼痛 妊娠结局 

分 类 号：R714.3[医药卫生—妇产科学]