椎管内分娩镇痛对孕妇妊娠结局的影响

Effect of Intraspinal Labor Analgesia on the Pregnancy Outcome of Pregnant Women

目的:探讨椎管内分娩镇痛对孕妇妊娠结局的影响。方法:选取2018年1-6月于笔者所在医院分娩的2 400例孕妇,随机分为观察组和对照组,每组1 200例。观察组给予椎管内分娩镇痛,对照组采取自然分娩(未行分娩镇痛)。结果:两组分娩方式及妊娠结局比较,差异均无统计学意义(P>0.05)。观察组第一产程、第二产程和总产程时长均长于对照组,差异均有统计学意义(P<0.05)。观察组与对照组新生儿Apgar评分、第三产程时长、产后出血率及产后2、24 h出血量比较,差异均无统计学意义(P>0.05)。观察组产时发热率、羊水污染及胎膜早破发生率均高于对照组,差异均有统计学意义(P<0.05)。结论:椎管内分娩镇痛可延长孕妇第一产程、第二产程和总产程时长,并可导致孕妇出现产时发热,但对新生儿窒息、产后出血率、产后出血量及第三产程时长无不良影响。

Objective:To investigate the effect of intraspinal labor analgesia on the pregnancy outcome of pregnant women.Method:A total of 2 400 pregnant women who were delivered in our hospital from January to June 2018 were randomly divided into the observation group and the control group,with 1 200 cases in each group.The observation group was given intraspinal labor analgesia,and the control group was given natural delivery(no labor analgesia).Result:The mode of delivery and pregnancy outcome were compared between the two groups,and the differences were not statistically significant(P>0.05).The first stage of labor,the second stage of labor and the total stage of labor in the observation group were longer than those of the control group,and the differences were statistically significant(P<0.05).The Apgar score,the third stage of labor,the postpartum hemorrhage rate and the amount of bleeding at 2 and 24 h postpartum were compared between the observation group and the control group,and the differences were not statistically significant(P>0.05).The rates of fever during delivery,incidences of amniotic fluid contamination and premature rupture of membrane in the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion:Intraspinal labor analgesia can prolong the first stage of labor,the second stage of labor and the total stage of labor,and may lead to fever during delivery,but has no adverse effects on neonatal asphyxia,postpartum hemorrhage rate,postpartum bleeding volume,and third stage of labor.