导乐联合硬膜外镇痛在分娩潜伏期的应用

Combined Application of Doula and Epidural Analgesia for Labor-pain Relief during Latent Phase of Labor

目的探讨导乐联合硬膜外镇痛在分娩潜伏期应用的有效性及安全性。方法选择2008年6-12月自愿接受分娩镇痛的单胎、足月临产初产妇318例,均施行硬膜外镇痛分娩,并由资深导乐助产士进行全程陪产。其中潜伏期宫口<2cm实施镇痛者159例为研究组,活跃期宫口>3cm实施镇痛者159例为对照组。观察两组产妇的镇痛效果、产程、催产素使用情况、分娩方式、产后出血、新生儿Apgar评分等。结果研究组和对照组产妇组内镇痛效果均有统计学意义(P<0.01),但组间无统计学差异;研究组第一产程较对照组缩短(P<0.05);两组的第二产程、第三产程、分娩方式、催产素使用情况、产后出血量及新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论导乐联合硬膜外镇痛分娩应用于潜伏期能早期有效地缓解分娩疼痛,促进产程进展,对分娩方式和母婴安全无影响,是分娩期切实可行的镇痛方法。

Objective To explore the effectiveness and safety of Doula combined with epidural analgesia during latent phase of labor. Methods The data from 318 nulliparous women who underwent epidural labor analgesia plus Doula by qualified midwife from Jun. to Dec. 2008 were retrospectively analyzed. The analgesia was given either at cervical dilations of less than 2 cm in 159 women （research group） or at greater than 3 cm in 159 women （control group）. Comparisons in the analgesic efficiency, labor duration, oxytocin use, mode of delivery, post-partum haemorrhage and Apgar scores were performed in the two groups. Results There was statistical significance of the analgesic effect in the two groups（P〈0.01）but no significant difference between the two groups. The first stage of labor in the research group was shootered compared to the contral grup （P〈0.05）. There were no significant differences between the two groups in the second and third stage of labor, mode of delivery, post-partum haemorrhage and newborns Apgar scores（P〉0.05）. Conclusion The early administration of Doula combined with epidural analgesia in latent phase of labor is feasible for labor pain relief, which can effectively relieve pain, quicken labor process, with no impact on mode of delivery and maternal or fetal safety.