全产程腰硬联合阻滞分娩镇痛在瘢痕子宫妊娠阴道试产中的应用效果

Application effect of labor analgesia using combined spinal-epidural anesthesia during a trial of vaginal labor in puerperae with cesarean scar pregnancy

目的探讨全产程腰硬联合阻滞分娩镇痛在瘢痕子宫妊娠阴道试产中的应用效果。方法选取60例符合阴道试产的瘢痕子宫妊娠产妇为观察组,60例足月妊娠符合阴道试产的初产妇为对照组。两组全产程均采用腰硬联合阻滞分娩镇痛。比较两组产妇的产程、产后出血量、疼痛视觉模拟量表(VAS)评分及分娩结局。结果两组产妇的VAS评分比较,差异无统计学意义(P>0.05),两组的VAS评分均有随时间变化的趋势(P<0.05),分组与时间无交互效应(P>0.05)。两组产妇均未出现麻醉相关及产后并发症,产后出血量、第二产程时间、新生儿1min Apgar评分、新生儿体重及剖宫产率比较,差异均无统计学意义(均P>0.05),但观察组第一产程时间短于对照组(P<0.05)。结论全产程腰硬联合阻滞分娩镇痛用于瘢痕子宫妊娠产妇阴道试产效果确切,安全性较高。

Objective To explore the application effect of laboRanalgesia using combined spinal-epidural anesthesia during a trial of vaginal laboRin puerperae with cesarean scaRpregnancy.Methods Sixty puerperae with cesarean scaRpregnancy eligible foRa trial of vaginal laboRwere selected as observation group,and 60 full-term primiparas eligible foRa trial of vaginal laboRas control group.Both groups received combined spinal-epidural laboRanalgesia during delivery.Stage of labor,postpartum blood loss,Visual Analogue Scale(VAS)score,and delivery outcome were compared between the two groups.Results There was no statistically significant difference in VAS score between the two groups(P>0.05),VAS score changed with time in both groups(P<0.05),and there was no interaction between grouping effect and time effect(P>0.05).No anesthesia-related oRpostpartum complications occurred in the two groups.There was no statistically significant difference between the two groups in postpartum blood loss,duration of the second stage of labor,neonatal 1-minute ApgaRscore,weight of the newborn,oRrate of cesarean section(all P>0.05),however,the observation group exhibited shorteRduration of the first stage of laboRthan the control group(P<0.05).Conclusions LaboRanalgesia using combined spinal-epidural anesthesia during a trial of vaginal laboRachieves a definite efficacy and higheRsafety in puerperae with cesarean scaRpregnancy.