腰硬联合麻醉无痛分娩对分娩方式的影响

Influence of painless labor by combined spinal-epidural anesthesia on delivery mode

目的探讨腰硬联合麻醉无痛分娩对分娩方式选择的影响。方法选择在德州市妇幼保健院经阴试产的初产妇628例，其中接受腰硬联合麻醉无痛分娩252例为观察组，未接受无痛分娩的376例为对照组，比较两组间的疼痛程度、产程时间和社会因素剖宫产情况。结果观察组疼痛程度显著轻于对照组（X^2=430．18，P〈0．01），观察组社会因素剖宫产率显著低于对照组（10．53％vs59．72％,X^2=14．56，P〈0．01），观察组第一产程时间明显短于对照组（5．73±1．01hvs7．90±1．38h，t=19．757，P〈0．05）。结论开展腰硬联合麻醉无痛分娩可显著减轻疼痛、缩短产程，提高自然分娩率，降低社会因素剖宫产率。

Objective To explore the influence of painless labor by combined spinal-epidural anesthesia on selection of delivery mode. Methods Altogether 628 primipara taking trial vaginal labor were selected from Dezbou Municipal Maternal and Child Health Hospital, including 252 cases accepting combined spinal-epidural anesthesia （observation group） and 376 cases of not accepting it （control group）. The pain degree, duration of labor and social factors of cesarean section of two groups were compared. Results The pain degree in observation group was significantly weaker than that in control group （X2 = 430. 18, P 〈 0.01 ）. The rate of cesarean section caused by social factors in observation group was significantly lower than that in control group （ 10.53% vs 59.72% ,X^2 = 14.56, P 〈 0.01 ）. And the duration of first stage of labor was obviously shorter than that of control group （5.73± 1.01 h vs 7.90 ±1.38h, t = 19.757, P 〈 0.05 ）. Conclusion Painless labor by combined spinal-epidural anesthesia can effectively relieve pain, shorten stage of labor, improve natural birth rate and reduce the rate of cesarean caused by social factors.