分娩镇痛对瘢痕子宫再次妊娠产妇经阴道顺产产程的影响分析  

The Analysis of the Impact of Labor Analgesia on the Vaginal Delivery Process in Women with a Scarred Uterus during Subsequent Pregnancy

作　　者：李继成 李刚 LI Ji-cheng;LI Gang(Department of Anesthesia,Xiaogan Maternal and Child Health Hospital,Xiaogan 432100,Hubei Province,China;Department of General Surgery,Xiaogan Maternal and Child Health Hospital,Xiaogan 432100,Hubei Province,China)

机构地区：[1]孝感市妇幼保健院麻醉科,湖北孝感432100 [2]孝感市妇幼保健院普外科,湖北孝感432100

出　　处：《罕少疾病杂志》2025年第4期96-98,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨分娩镇痛在瘢痕子宫再次妊娠产妇经阴道顺产中的应用效果。方法于2022年1月至2022年12月时段采集病例入档,对象为医院收治的瘢痕子宫再次妊娠产妇,纳入50例患者,均具备阴道试产指征并接受阴道顺产,基于“随机数字表法”1:1分组,划分为对照组(未进行分娩镇痛处理)与观察组(实施分娩镇痛),各25例;对比两组产程时间、产后24h出血量、试产成功率、新生儿Apgar评分、镇痛效果、血清应激反应指标。结果观察组较对照组第二产程时间延长(P<0.05),两组第三产程时间对比无差异(P>0.05);观察组阴道试产成功率高于对照组(P<0.05),两组产后出血量、产钳助产率对比无差异(P>0.05);两组新生儿体质量和1min、5minApgar评分比较无差异(P>0.05);观察组宫口开3cm、宫口开7~8cm、宫口全开时的VAS明显低于对照组(P<0.05);分娩前,两组应激反应指标对比(P>0.05),观察组宫口开7-8cm、宫口全开、分娩后的血清NE、Cor、E均明显低于对照组(P<0.05)。结论瘢痕子宫再次妊娠产妇实施分娩镇痛可显著减轻疼痛程度,以降低应激反应,提高阴道顺产率,可延长第二产程时间,但对妊娠结局无影响。Objective To explore the application effect of labor analgesia in vaginal delivery during subsequent pregnancies in women with a scarred uterus.Methods Cases were collected from January 2022 to December 2022.The subjects were women with a scarred uterus who were admitted to the hospital for subsequent pregnancies.A total of 50 patients who met the criteria for a trial of labor and underwent vaginal delivery were included.The participants were randomly divided into two groups using the"random number table method"in a 1:1 ratio:the control group(no labor analgesia)and the observation group(with labor analgesia),each consisting of 25 cases.The two groups were compared for labor duration,24-hour postpartum blood loss,trial of labor success rate,neonatal Apgar scores,analgesic effect,and serum stress response indicators.Results The second stage of labor duration in the observation group was longer than that in the control group(P<0.05).There was no significant difference in the third stage of labor duration between the two groups(P>0.05).The trial of labor success rate in the observation group was higher than in the control group(P<0.05).There was no significant difference between the groups regarding postpartum blood loss or the rate of forceps-assisted delivery(P>0.05).There were no significant differences in neonatal birth weight or 1-minute and 5-minute Apgar scores between the two groups(P>0.05).The VAS scores for the observation group were significantly lower than those in the control group at 3 cm dilation,7-8 cm dilation,and full dilation(P<0.05).Before delivery,there were no significant differences in stress response indicators between the two groups(P>0.05).However,at 7-8 cm dilation,full dilation,and postpartum,the serum levels of NE,Cor,and E in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Labor analgesia in women with a scarred uterus during subsequent pregnancies can significantly reduce pain,decrease stress responses,and increase the vaginal delivery

关 键 词：分娩镇痛 瘢痕子宫 再次妊娠 阴道顺产 产程时间 

分 类 号：R714.3[医药卫生—妇产科学]