硬膜外阻滞分娩镇痛在初产妇的效果及影响

Clinical observation of epidural obstructive labor and analgesia in primiparas

目的探讨硬膜外阻滞分娩镇痛在初产妇的效果以及对产程、母婴结局的影响。方法选择2016年8月至2016年9月分娩的初产妇400例,随机分为2组,每组200例,研究组采用硬膜外阻滞实施分娩镇痛,对照组不给予任何镇痛措施,比较2组产妇的分娩各阶段VAS评分、宫缩情况、胎心率、胎儿娩出时血流动力学、剖宫产率、分娩产程所用时间、产后出血量、新生儿Apgar评分以及产后并发症发生情况。结果研究组产妇分娩各阶段(宫口开3cm、宫口开6cm、宫口开全)VAS评分低于对照组(P<0.05),2组产妇的宫缩时间、胎心率、胎儿娩出时孕妇平均动脉压、心率以及脉搏氧饱和度比较差异无统计学意义(P>0.05)。研究组由自然分娩改为剖宫产的15例,剖宫产率为7.5%;对照组有37例,剖宫产率为18.5%,2组比较差异有统计学意义(P<0.05)。研究组第一产程(10.83±0.76)h低于对照组第一产程(12.41±0.97)h(P<0.05);2组在产后出血量和新生儿Apgar评分比较差异无统计学意义(P>0.05);2组在产后出血、产后4 h排尿、会阴裂伤发生情况比较差异无统计学意义(P>0.05)。结论硬膜外阻滞分娩镇痛技术可以缓解产妇分娩过程中的疼痛感,缩短产程,降低剖宫产率,而且对母婴安全影响较小。

Objective To analyze the effect of painless epidural anesthesia in primiparas and the influence on the outcome of labor and mother and infant.Methods 400 cases of primiparas from August 2016 to September 2016 in our hospital,200 cases of the study group were used epidural anesthesia technique,200 cases of control group were not given any analgesic measures,the maternal pain grade distribution,uterine contraction,fetal heart rate,fetal childbirth time delivery rate,hemodynamics,planing by the time of birth process,postpartum hemorrhage,neonatal Appar score,postpartum complications were compared between the 2 groups.Results The results showed that the distribution of pain in study group was significantly better than the control group（P〈0.05）,two groups of maternal uterine contraction time,fetal heart rate,fetal childbirth pregnant women mean arterial pressure,heart rate and pulse oxygen saturation had no significant difference（P〉0.05）.15 patients in the study group expected through natural childbirth switched to cesarean section delivery,plane palace yield was 7.5%,while 37 cases in the control group had switched to cesarean section delivery the plane section rate was 18.5%,there was significant difference between two groups（P〈0.05）.The first birth processof the study group（10.83±0.76） h was shorter than that in the control group（12.41±0.97） h（P〈0.05）,there was no statistically significant difference in the amount of postpartum hemorrhage and neonatal Appar score in the two groups（P〉0.05）,there was no significant difference between the 2 groups considering postpartum bleeding,urination,perineal laceration（P〉0.05）.Conclusion Epidural block anesthesia painless delivery technology can relieve the pain and pain in the delivery process,shorten the labor process,reduce the cesarean section rate,and have less influence on the safety of mother and baby.