新产程标准在温州地区临床应用的可行性

Feasibility study on clinical application of the new labor standards in Wenzhou

目的:探讨新产程标准在温州地区临床应用的可行性。方法:回顾性分析温州医科大学附属第二医院分娩的单胎足月头先露初产妇的病例资料,根据有无分娩镇痛,分别比较新、旧产程组剖宫产率,产钳助娩率,产程时限,人工破膜率,催产素使用率,产时发热率,产后2 h出血量,新生儿窒息率等。结果:新产程组的剖宫产率及人工破膜率显著低于旧产程组,差异有统计学意义(P<0.01);新产程组剖宫产指征主要为胎儿宫内窘迫,旧产程组剖宫产指征主要为活跃期延缓和停滞;分娩镇痛下,新产程组催产素使用率、产时发热率、第一及第二产程时间、产后2 h出血量及新生儿窒息率明显高于旧产程组,差异均有统计学意义(P<0.05)。结论:新产程标准虽增加了催产素使用率、产时发热率、新生儿窒息率,但降低了剖宫产率和人工破膜率。

Objective:To explore the feasibility of application of the new labor standards in Wenzhou.Methods:A retrospective analysis was performed in the Second Affiliated Hospital of Wenzhou Medical University.Objects included were primiparas who had singleton full-term primipara,cephalic presentation and spontaneous delivery.The study was divided into new and old labor group.According to whether labor analgesia implemented,the two groups were compared respectively in the Cesarean delivery rate(CDR),rate of artificial rupture,rate of forceps delivery,duration of labor,rate of intrapartum fever,postpartum hemorrhage in2hours and incidence of neonatal asphyxia.Results:The CDR and the rate of artificial rupture of the new labor group was significantly decrease compared with the old labor group(P<0.01);The main Cesarean section indications of the new labor group was fetal distress,while that under the condition of the old labor group was protracted and arrested active phase;With the implementation of labor analgesia,rate of oxytocin usage,rate of intrapartum fever,span of the first and the second stage of labor,postpartum hemorrhage in2hours and incidence of neonatal asphyxia in the new labor group were significantly higher than that in the old labor group(P<0.05).Conclusion:Although the new labor standards increased the rate of oxytocin usage,the rate of intrapartum fever and the incidence of neonatal asphyxia,it reduced the initial CDR and the rate of artificial rupture.In general,the new labor standard is worth to popularize.