潜伏期与活跃期硬膜外分娩镇痛对产妇产程及母胎结局的影响  

The effects of epidural analgesia during the latent and active phases of labor on labor progress and maternal-fetal outcomes

作　　者：邓宗辉 李一帆 刘丽芳 Deng Zonghui;Li Yifan;Liu Lifang(Department of Anesthesiology,Fengcheng Maternal and Child Health Hospital,Fengcheng 331100,China;Department of Anesthesiology,Ningdu Chengnan Hospital,Ganzhou 342800,China)

机构地区：[1]丰城市妇幼保健院麻醉科,丰城331100 [2]宁都城南医院麻醉科,赣州342800

出　　处：《实用医技杂志》2024年第12期895-898,共4页Journal of Practical Medical Techniques

摘　　要：目的分析硬膜外分娩镇痛对产妇在潜伏期与活跃期的效果以及对产妇的影响。方法选取2021年12月至2023年12月本院收治的82例产妇为研究对象,并按照随机数字表法分为潜伏组和活跃组各41例,潜伏组于潜伏期(宫口开至1 cm)镇痛,活跃组于活跃期(宫口开至3 cm)镇痛,对比2组产程相关指标、疼痛情况、产妇临床相关指标及母胎结局。结果对比2组第三产程时间,在镇痛前、镇痛后10 min,镇痛后20 min、宫口扩张至7~8 cm时及宫口开至10 cm时的心率与平均动脉压,镇痛前与宫口开至7~8 cm时的疼痛视觉模拟评分(VAS)以及出现的产褥感染、产后出血、胎儿窘迫、新生儿窒息情况,差异均无统计学意义(P>0.05);活跃组宫口扩张速度快于潜伏组,且活跃期时间与第二产程时间长于潜伏组,镇痛后10、20 min与宫口开至10 cm时,活跃组产妇VAS评分高于潜伏组,差异有统计学意义(P<0.05)。对比2组产妇远期不良反应,差异均无统计学意义(P>0.05)。结论在潜伏期与活跃期对产妇进行硬膜外分娩镇痛,镇痛效果均确切,但在潜伏期进行分娩镇痛可以缩短产程时间,加快分娩,缓解产妇第一产程疼痛感。Objective To analyze the effect of epidural labor analgesia on pregnant women in the latent period and active period and its influence on pregnant women.Methods Eighty-two cases of parturient women admitted to our hospital from December 2021 to December 2023 were selected as research subjects,and were divided into latent group and active group with 41 cases in each group according to random number table method.The latent group received analgesia during the incubation period(uterine opening to 1 cm),while the active group received analgesia during the active period(uterine opening to 3 cm).The relative indexes of labor,pain,maternal clinical indexes and maternal-fetal outcomes were compared between the two groups.Results The heart rate and mean arterial pressure before analgesia,10 min after analgesia,20 min after analgesia,when uterine orifice was dilated to 7~8 cm and when uterine orifice was opened to 10 cm were compared between the two groups.There were no significant differences in VAS scores before analgesia and when uterine opening was 7~8 cm,and in puerperal infection,postpartum hemorrhage,fetal distress and neonatal asphyxia(P>0.05).The dilation rate of the active group was faster than that of the latent group,and the duration of the active phase and the second stage of labor was longer than that of the latent group.The VAS score of the active group was higher than that of the latent group 10 and 20 min after analgesia and when the uterine opening reached 10 cm,the difference was statistically significant(P<0.05).Compared with the two groups of maternal long-term adverse reactions,the difference was not significant(P>0.05)Conclusion Epidural labor analgesia is effective in both the latent period and the active period.However,labor analgesia during the latent period can shorten labor time,speed up labor and relieve the pain of the first stage of labor.

关 键 词：镇痛 硬膜外 分娩疼痛 分娩 产道 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]