分娩镇痛对第二产程及分娩方式的影响

The effect of labor analgesia on the second labor stage and mode of delivery

目的探讨分娩镇痛对第二产程及分娩方式的影响。方法采用回顾性分析的方法,将大连市妇产医院2012年8月～2013年2月施行硬膜外阻滞分娩镇痛的200例单胎、初产妇作为研究组,未施行分娩镇痛的50例产妇为对照组,于宫口开达3cm时使用罗派卡因进行连续的硬膜外阻滞麻醉。比较两组产妇在第二产程及分娩方式的差异。结果研究组的第二产程延长发生率为23.50%,二产程停滞发生率为17.50%,对照组第二产程延长发生率为10.00%,二产程停滞发生率为6.00%,差异有统计学意义(P<0.05)。研究组剖宫产率为10.50%,产钳助产率为20.00%,对照组剖宫产率为10.00%,产钳助产率为8.00%,两组间剖宫产率差异无统计学意义(P>0.05),但是产钳助产率两组间差异有统计学意义(P<0.05)。结论分娩镇痛与第二产程延长、二产程停滞及产钳助产有关,但是与剖宫产无关。

Objective To explore the effect of labor analgesia on the second labor stage and mode of delivery. Methods Retrospective analyzed totally 200 cases of single primipara were analyzed retrospectively in Dalian obstetrics and gynecology hospital from Aug. 2012 to Feb. 2013, who accepted spinal-epidural anesthesia while the uterine mouth opening to 3 cm to be as study subjects. 50 cases of single pregnancy women who didn＇t accept spinal-epidural anesthesia for the control group. The differences were compared between them in the second stage of labor and delivery mode. Results The incidence of prolonged second stage of labor was 23.50%, and that of the second stage stagnation was 17.50% in the study group. The incidence of prolonged second stage of labor was 10.00%, and that of the second stage of stagnation was 6.00% in the control group. Significant difference was shown between two groups （P 0.05）; The incidence of cesarean section was 10.50% and which obstetric forceps was 20.00% in the study group. The incidence of cesarean section was 10.00%, and which obstetric forceps was 8.00% in the control group, significant difference was shown between two groups in obstetric forceps （P 0.05）, but no significant difference in cesarean section （P 0.05）. Conclusion Labor analgesia is relevant to the second stage prolonging, the second stage stagnation and forceps delivery, but it has nothing to do with cesarean section.