硬膜外分娩镇痛对产程时间及分娩结局的影响

Effect of epidural labor analgesia on the duration of labor and delivery outcome

目的探讨硬膜外分娩镇痛对产程时间及分娩结局的影响。方法选取2014年11月-2016年11月在衢州市妇幼保健院妇产科住院分娩的300例产妇为研究对象,采用回顾性分析方法对其临床资料进行分析,并根据有无分娩镇痛需要将研究对象分为干预组(150例,给予硬膜外分娩镇痛)和对照组(150例,不给予任何镇痛处理)。对两组产妇的产程时间、产妇疼痛程度、催产素使用情况、分娩方式及新生儿Apgar评分进行综合评价。结果干预组产妇的疼痛程度和第一产程时间显著低于对照组,产妇催产素和产钳使用率及第二产程时间高于对照组,两组比较,差异均有统计学意义(P<0.05);两组新生儿Apgar评分比较,差异均无统计学无意义(P>0.05)。结论对分娩产妇给予硬膜外镇痛,会延长第二产程时间,增加阴道助产率,缩短总产程时间,降低分娩疼痛,对产妇分娩方式及新生儿结局无影响,是一种安全、有效的镇痛方式。

Objective To explore the effect of epidural labor analgesia on the duration of labor and delivery outcome. Methods A total of 300 women who delivered in Department of Obstetrics and Gynecology in Quzhou Maternal and Child Health Care Hospital from November 2014 to November 2016 were selected as study objects,and their clinical data was retrospectively analyzed. According to the need for labor analgesia or not,the cases were divided into intervention group and control group,150 cases in each group. The cases in intervention group were given epidural labor analgesia,while the cases in control group were not given any analgesic treatment. The labor time,maternal pain degrees, use of oxytocin, modes of delivery, and neonatal Apgar scores in the two groups were evaluated comprehensively.Results Maternal pain degree and time of the first stage of labor in intervention group were statistically significantly lower than those in control group,the utilization rates of oxytocin and forceps,and time of the second stage of labor in intervention group were statistically significantly higher than those in control group（ P 〈0. 05）. There was no statistically significant difference in neonatal Apgar score between intervention group and control group（ P 〈0. 05）. Conclusion Epidural labor analgesia can prolong the time of the second stage of labor,increase the rate of vaginal delivery,shorten the total labor time,reduce the pain of childbirth,and it has no effect on the modes of delivery and neonatal outcome,which is a safe and effective analgesic method.