腰-硬联合阻滞分娩镇痛对第二产程、软产道及新生儿的影响

Effect of combined spinal-epidural analgesia on second stage of labor,softbirth canal and neonatal outcome during spontaneous vaginal delivery

目的探讨腰-硬联合阻滞分娩镇痛是否影响第二产程进展、阴道器械助产、软产道损伤、新生儿结局。方法选取我院实施分娩镇痛并阴道分娩的产妇360例为观察组,选取同期未实施分娩镇痛并阴道分娩的产妇900例为对照组。观察两组的第二产程时间、阴道器械助产、软产道损伤情况、新生儿结局。结果观察组和对照组第二产程时间分别为:(52.5±23.3)min、(48.7±29.1)min,阴道器械助产率分别为:3.9%和3.6%,两组间比较差异均无统计学意义(P>0.05);观察组、对照组的会阴裂伤率分别为7.0%、7.7%,阴道裂伤率分别为3.6%、4.1%,两组间比较差异均无统计学意义(P>0.05);观察组、对照组新生儿出生1分钟的轻度窒息和重度窒息发生率分别为:8.6%vs9.7%,1.4%vs 1.6%,出生5分钟的轻度窒息和重度窒息发生率分别为:2.2%vs 2.6%,0.3%vs 0.3%,两组间比较差异均无统计学意义(P>0.05)。结论腰-硬联合阻滞分娩镇痛不延长第二产程时间,也不增加阴道器械助产率、软产道损伤率及新生儿窒息发生率。

Objective:To study the effect of combined spinal-epidural analgesia(CSEA)on the second stage of labor,instrumental delivery rate,obstetric lacerations and neonatal parameters during spontaneous vaginal delivery.Methods:360parturients who accepted CSEA were selected as study group,meanwhile900parturients without CSEA were selected as control group,and all had vaginal delivery.The duration of the second stage of labor,mode of delivery,obstetric lacerations and neonatal outcome were compared between the two groups.Results:There were no significant differences in duration of the second stage of labour(52.5±23.3min vs48.7±29.1min)and instrumental delivery rate(3.9%vs3.6%)between the two groups(P>0.05).No statistically significant difference was found in the rate of perineal tears(7.0%vs7.7%)and vaginal trauma(3.6%vs4.1%)between the two groups(P>0.05).No significant difference in the rate of1stmin mild and severe neonatal asphyxia(8.6%vs9.7%,1.4%vs1.6%),and5th min mild and severe neonatal asphyxia(2.2%vs2.6%,0.3%vs0.3%)between the two groups(P>0.05).Conclusion:CSEA has no impact on duration of the second stage of labor,rate of instrumental delivery rate,obstetric lacerations and neonatal asphyxia.