椎管内阻滞麻醉对产妇产程时间、产后出血及分娩结局的影响  

Effects of intraspinal block anesthesia on labor time, postpartum hemorrhage and delivery outcome of parturients

作　　者：范冉 FAN Ran(Anesthesia Department,Xuchang Hospital,Xuchang 461000,China)

机构地区：[1]许昌医院麻醉科,河南许昌461000

出　　处：《临床医学研究与实践》2025年第3期75-78,共4页Clinical Research and Practice

摘　　要：目的 探讨椎管内阻滞麻醉对产妇产程时间、产后出血及分娩结局的影响。方法 选取2021年10月至2022年12月我院收治的144名待产产妇,按照随机数字表法将其分为试验组和对照组,各72名。对照组采用导乐分娩镇痛仪,试验组在对照组的基础上实施椎管内阻滞麻醉。比较两组的妊娠结局、产程时间、疼痛程度、炎症因子及产后出血情况。结果 两组的顺产、器械助产率比较,差异无统计学意义(P>0.05);试验组的中转剖宫产率为2.78%,低于对照组的15.28%(P<0.05)。试验组的第一产程及总产程时间短于对照组(P<0.05);两组的第二、三产程时间比较,差异无统计学意义(P>0.05)。第一、二、三产程,试验组的视觉模拟量表(VAS)评分均低于对照组(P<0.05)。第一、二、三产程,试验组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。试验组的产后2、24 h出血量少于对照组(P<0.05);两组的产后出血率比较,差异无统计学意义(P>0.05)。结论 椎管内阻滞麻醉能有效缩短产妇的产程时间,缓解疼痛,促进产程顺利进行,减轻炎症损伤,减少产后出血量。Objective To investigate the effects of intraspinal block anesthesia on labor time,postpartum hemorrhage and delivery outcome of parturients.Methods A total of 144 expectant parturients admitted in our hospital from October 2021 to December 2022 were selected and divided into experimental group and control group according to the random number table method,with 72 parturients in each group.The control group was treated with Doula labor analgesia instrument,and the experimental group was treated with intraspinal block anesthesia on the basis of the control group.The pregnancy outcome,labor time,pain degree,inflammatory factors and postpartum hemorrhage were compared between the two groups.Results There were no significant differences in the rates of spontaneous delivery and instrumental midwifery between the two groups(P>0.05);the transfer rate of cesarean section in the experimental group was 2.78%,which was lower than 15.28%in the control group(P<0.05).The first stage of labor and total labor time in the experimental group were shorter than those in the control group(P<0.05);there were no significant differences in the second and third stages of labor time between the two groups(P>0.05).At the first,second and third stages of labor,the Visual Analogue Scale(VAS)score in the experimental group was lower than that in the control group(P<0.05).At the first,second and third stages of labor,the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the experimental group were lower than those in the control group(P<0.05).The amount of bleeding at 2 and 24 h after delivery in the experimental group were less than those in the control group(P<0.05);there was no significant difference in the rate of postpartum hemorrhage between the two groups(P>0.05).Conclusion Intraspinal block anesthesia can effectively shorten the labor time,relieve pain,promote the smooth progress of labor,reduce inflammatory injury,and decrease postpartum hemorrhage.

关 键 词：椎管内阻滞麻醉 产妇 产程时间 产后出血 分娩结局 

分 类 号：R614.4[医药卫生—麻醉学]