地西泮对椎管内镇痛分娩宫颈水肿孕妇产程及母婴结局的影响  

Effect of diazepam on the progress of labor and maternal and infant outcomes in pregnant women with cervical edema receiving intraspinal labor analgesia

作　　者：姜文侠 陈婧盈 岳永飞 JIANG Wenxia;CHEN Jingying;YUE Yongfei(Department of Obstetrics and Gynecology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou Maternal and Child Health Hospital,Jiangsu,Suzhou 215002,China)

机构地区：[1]南京医科大学附属苏州医院、苏州市立医院、江苏省苏州市妇幼保健院妇产科,江苏苏州215002

出　　处：《中国医药科学》2025年第4期53-56,共4页China Medicine And Pharmacy

基　　金：江苏省妇幼健康科研项目(F202108);姑苏卫生人才计划(GSWS2023055)。

摘　　要：目的研究地西泮对椎管内镇痛分娩宫颈水肿孕妇产程及母婴结局的影响。方法回顾性分析2024年2—7月南京医科大学附属苏州医院收治的在镇痛分娩中宫口2~3 cm宫颈水肿、产程进展缓慢孕妇170例,其中85例使用地西泮为研究组,85例未使用地西泮为对照组,比较两组孕妇产程及母婴围生期结局。结果两组研究对象的年龄、孕次、产次、体重指数、分娩孕周差异无统计学意义(P>0.05)。研究组的产前发热[15例(17.65%)]vs.[28例(32.94%)]、中转剖宫产[29例(34.12%)]vs.[43例(50.59%)]、第一产程、第二产程、宫口从2~3 cm扩张至5 cm时间、宫口从5 cm扩张至开全时间和脐血剩余碱数值均小于对照组,差异有统计学意义(P<0.05)。两组研究对象的会阴撕裂、会阴侧切、阴道助产、产后出血量和第三产程比较差异均无统计学意义(P>0.05)。两组研究对象的新生儿体重、Apgar评分(1 min、5 min)、脐血pH、新生儿窒息和入住新生儿重症监护室情况比较,差异均无统计学意义(P>0.05)。结论椎管内镇痛分娩的孕妇在宫颈水肿、产程进展缓慢时应用地西泮,可促进产程进展,降低剖宫产率,且不增加不良分娩结局,是安全有效的方法。Objective To investigate the effect of diazepam on the progress of labor and maternal and infant outcomes in pregnant women with cervical edema receiving intraspinal labor analgesia.Methods A retrospective analysis was conducted on 170 pregnant women with cervical edema at 2-3 cm of the uterine opening and slow progress of labor during analgesic delivery admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from February to July 2024.Of them,85 pregnant women using diazepam were classified as the test group,and 85 pregnant women not using diazepam were classified as the control group.The progress of labor and perinatal outcomes of mothers and infants were compared between the two groups.Results There were no statistical differences in age,gravidity,parity,body mass index,or gestational weeks of delivery between the two groups(P>0.05).The incidence of prenatal fever(15 pregnant women[17.65%])vs.(28 pregnant women[32.94%]),cesarean section rate(29 pregnant women[34.12%])vs.(43 pregnant women[50.59%]),duration of the first and second stages of labor,time from cervical dilation of 2-3 cm to 5 cm,time from cervical dilation of 5 cm to full dilation,and umbilical cord blood base excess value were lower in the test group than those in the control group,with statistically significant differences(P<0.05).Comparison of perineal laceration,lateral epis iotomy,assisted vaginal delivery,pos tpartum bleeding volum e,and the third stage of labor showed no statistical differences between the two groups(P>0.05).Comparison of neonatal weight,Apgar score(1 min,5 min),umbilical cord blood pH,neonatal asphyxia,and admission to the neonatal intensive care unit also showed no statistical differences between the two groups(P>0.05).Conclusion The use of diazepam in pregnant women with cervical edema and slow progress of labor receiving intraspinal labor analgesia can promote the progress of labor and reduce the cesarean section rate,with no increase in adverse delivery outcomes,making it a safe and effective method.

关 键 词：镇痛 产科 宫颈水肿 产程进展缓慢 地西泮 妊娠结局 

分 类 号：R714.3[医药卫生—妇产科学]