联合麻醉分娩镇痛对正常产妇分娩方式及产程的影响分析

Analysis of the Effect of Combined Labor Analgesia on Delivery Mode and Delivery of Normal Pregnant Women

目的:分析联合麻醉分娩镇痛对正常产妇分娩方式及产程的影响。方法:回归性分析笔者所在医院2014年8月-2016年10月收治的1134例正常产妇的临床资料,根据是否采用分娩镇痛分为对照组(n=497)和观察组(n=637)。对照组产妇未采用任何分娩镇痛措施,观察组患者则采用联合麻醉分娩镇痛。对比两组产妇阴道顺产、产钳助产、剖宫产的构成比及缩宫素的使用率;分别记录比较两组产妇胎儿窘迫、活跃期延长、第二产程延长、产后出血及新生儿窒息等情况;并将两组产妇各产程时间与总产程时间进行比较。结果:观察组产妇产钳助产率较高,剖宫产率较低,且缩宫素使用率较高,与对照组患者相比,差异有统计学意义(P<0.05);两组产妇阴道顺产率比较差异无统计学意义(P>0.05)。观察组产妇胎儿窘迫、活跃期延长、第二产程延长的发生率均比对照组高,差异均有统计学意义(P<0.05);但两组产妇产后出血及新生儿窒息发生率均较低,差异无统计学意义(P>0.05);观察组产妇第一产程、第二产程及总产程时间均长于对照组,差异均有统计学意义(P<0.05);两组产妇第三产程时间比较差异无统计学意义(P>0.05)。结论:联合麻醉分娩镇痛不能提高阴道顺产率,并且缩宫素使用率较高,还会增加胎儿窘迫、活跃期延长及第二产程延长的发生率,且第一产程、第二产程及总产程时间较长,因此对正常产妇需合理选择使用联合麻醉进行分娩镇痛。

Objective：To analyze the effect of combined labor analgesia on the delivery mode and labor process of normal pregnant women.Method：1134 cases of normal maternal clinical data of the author＇s hospital in August 2014 to October 2016 were analyzed,according to whether to use labor analgesia was divided into control group（n=497） and observation group（n=637）.The control group wasn,t given labor analgesia,while the observation group was treated with combined anesthesia.The maternal vaginal delivery rate,forceps delivery rate,cesarean section rate and utilization rate of contractions of two groups were compared.The maternal fetal distress,prolonged active phase,prolonged second stage of labor,postpartum hemorrhage and neonatal asphyxia of two groups were compared.The labor time and total labor time of two groups were compared.Result：The maternal forceps delivery rate and cesarean section rate of the observation group was lower,and the use of oxytocin was higher compared with the control group,the differences were statistically significant（P〈0.05）.There was no statistically significant difference of maternal vaginal birth rate in the two groups（P〉0.05）.The maternal fetal distress,prolonged active phase,prolonged second stage of incidence of the observation group were higher than those in control group,the differences were statistically significant（P〉0.05）.The postpartum hemorrhage and neonatal asphyxia were lower of two groups,but there was no statistically significant difference（P〉0.05）.The first stage of the labor,the second stage of the labor and total labor time of the observation group were significantly higher than those of the control group,the differences were statistically significant（P〉0.05）.There was no statistically significant difference of the third stage of labor time between the two groups（P〉0.05）.Conclusion：Combined anesthesia can improve the analgesic delivery of the vaginal delivery rate,and the use of oxytocin will increase the higher rate of fetal distress,prolonged active phase and prolonged second stage of incidence,and the first stage the second stage of labor and the total labor time is longer,so the normal production and reasonable use of combined anesthesia labor analgesia.