普贝生联合无痛分娩在足月产妇引产中的效果评价

Evaluation of the Effect of Propess Combined with Patient Controlled Epidural Analgesia(PCEA) in Term Labor Induction

目的:探讨普贝生联合硬膜外镇痛泵(PCEA)无痛分娩技术在足月妊娠引产中的临床效果。方法:以我院240例妊娠足月孕妇,宫颈Bishop评分<6分,单胎头位,无阴道分娩禁忌证的初产妇为研究对象随机分为3组,分别给予催产素、普贝生、普贝生联合硬膜外镇痛泵(PCEA)处理,观察并比较3组孕妇的宫颈Bishop评分、宫颈成熟度、用药至临产时间、用药至分娩时间、总产程、阴道分娩率、疼痛及对母儿的影响。结果:普贝生组及普贝生联合PCEA组在宫颈Bishop评分、促宫颈成熟度、用药至临产时间、用药至分娩时间、总产程、疼痛评分及阴道分娩率明显优于缩宫素组,差异均有统计学意义(P<0.05);普贝生联合PCEA组在用药至分娩时间、总产程、阴道分娩率及疼痛等方面与普贝生组比较,差异有统计学意义(P<0.05)。三组在新生儿窒息、产后出血发生率等方面均无显著性差异(P>0.05)。结论:普贝生联合PCEA用于足月引产是安全有效的,它能缩短产程,提高阴道分娩率,减少分娩疼痛,且对母婴无明显不良影响,适合在临床进一步研究和推广使用。

Objective To explore the effectiveness of propess combined with patient controlled epidural analgesia（ PCEA） in the induced labor of term pregnancy. Methods 240 primiparas were enrolled as study subjects in our hospital. They were full term,single pregnancy and head position,cervical Bishop score≤6 without vaginal delivery contraindications and they were randomly divided into three groups and separately given 3 processing modes of pitocin,propess,and propess combined with PCEA. The cervical Bishop score,cervical maturity,medication to delivery time,medication to delivery time,total stage of labor,vaginal delivery rate,pain and the influence on the mother and fetus were observed and compared between the 3 groups. Results The cervical Bishop score,cervical maturity,medication to labor time,medication to delivery time,the total labor,pain scores and the rate of vaginal delivery in propess group and propess combined with PCEA group were significantly better than those in pitocin group,the differences were statistically significant（ P 〈 0. 05）; the medication to delivery time,the total labor,vaginal delivery rate,pain and other aspects of in propess combined with PCEA were much better than those in propess group,the difference was statistically significant（ P 〈 0. 05）. There were no significant difference between the three groups in the incidence of fetal distress and postpartum hemorrhage（ P 〉 0. 05）. Conclusions The combined use of propess and PCEA for induction of term pregnancy is safe and effective. It can shorten the production process,improve vaginal delivery rate and reduce the pain of childbirth without obvious adverse effects on mother and infant,and it is suitable for use in further clinical study and promotion.