哌替啶联合徒手宫颈扩张对产妇产程进展的影响

The effect of pethidine combined with unarmed cervical expansion on stages of labor

目的探讨哌替啶联合徒手宫颈扩张对分娩期产程进展的影响。方法选取单胎足月头位、无头盆不称及胎位异常、临产后宫缩正常的初产妇120例，随机分为实验组和对照组60例。对照组常规进行分娩期护理，实验组在常规分娩期护理的基础上，宫口扩张2～3cm时给予哌替啶100mg＋盐酸异丙嗪25mg肌肉注射和活跃期单纯徒手宫颈扩张。观察一二产程的时间、产妇的疼痛分级、胎儿窘迫、新生儿窒息及产后出血情况。结果实验组产妇产程活跃期明显缩短，第二产程缩短，疼痛减轻，胎儿窘迫和新生儿窒息发生率降低，顺产率提高。两组比较差异有统计学意义（P〈0．05）。结论哌替啶联合徒手宫颈扩张能有效减轻或消除分娩疼痛，缩短产程，提高分娩期母婴安全，可有效提高顺产率，降低剖宫产率。

Objective To study the effect and side - effect of pethidine intramuscular injection combined with unarmed cervical expansion on stages of labor. Methods A total of 120 normal primiparas were divided randomly into two groups. 60 primiparas served as the experimental group （ Group A） and received pethidine intramuscular injection and unarmed cervical expansion; 60 primiparas were measured as the control group （Group B ） , treated with normal care. There was no statistical significance in primiparas in two groups with age, weight, gestational weeks and fetal head size （ P 〉 0. 05 ） . Stages of labor, pain rating scales of puerperas, fetal distress and postpartum hemorrhage were observed. Results Both of active phase and second stage of labor were shorten ed in group A. The cases of normal delivery increased in group A than that in group B. There were significant differences between two groups. Conclusions Pethidine intramuscular injection combined with unarmed cervical expansion can shorten active phase and second stage of labor, reduce postpartum hemorrhage, abate pain of puerperas, decrease fetal distress and asphyxia neonatorum and decrease rate of caesarean section.