持续镇痛分娩对产妇分娩结局和新生儿评分的影响

Effect of Continuous Analgesia on the Delivery Outcome and Neonatal Score of Parturients

目的:研究持续镇痛分娩对产妇分娩结局和新生儿评分的影响。方法:选择2018年7月~2019年7月中国医科大学航空总医院(本院)采取硬膜外分娩镇痛的101例产妇,将其随机分为两组。当产生确切的镇痛效果,进入第二产程后,观察组的51例产妇采用0.4μg/m L舒芬太尼以及0.08%罗哌卡因进行持续镇痛分娩;对照组的50例产妇则在宫口开全后,使用生理盐水替代泵内的局麻药物,直到分娩结束。比较两组产妇催产素的使用率,宫口扩张度和第一、第二产程按压硬膜外自控镇痛泵的次数,分娩方式,新生儿的体质量,脐动脉血pH值,出生后1 min和5 min Apgar评分,产妇修复会阴部时的视觉模拟评分(visual analogue scale, VAS)评分及产妇对于第二产程镇痛的满意度评分。结果:两组产妇催产素的使用率、宫口扩张度和第一、第二产程按压硬膜外自控镇痛泵的次数、分娩方式(剖宫产率、器械助产率、自然分娩率)、第一产程镇痛时间、第一以及第二产程时间相比均无显著差异(P>0.05);两组新生儿的体质量,脐动脉血pH值,出生后1 min和5 min Apgar评分小于8分的新生儿所占的比例相比没有明显的差异(P>0.05);观察组产妇修复会阴部时的VAS评分明显低于对照组(P<0.05),产妇对于第二产程镇痛的满意度评分明显高于对照组(P<0.05)。结论:持续镇痛分娩对产妇分娩结局和新生儿评分无明显的影响,但可显著提高产妇对第二产程镇痛和修复会阴部时镇痛的满意度。

Objective: To study the effect of continuous analgesia on delivery outcome and neonatal score of parturients. Methods:From July 2018 to July 2019, 101 parturients with epidural analgesia in our hospital from July 2018 to July 2019 were randomly divided into two groups. When the exact analgesic effect was achieved, after entering the second stage of labor, 51 parturients in the observation group used 0.4 ug/mL sufentanil and 0.08 % ropivacaine for continuous analgesia delivery. 50 parturients in the control group used physiological saline the local anesthetics in the pump after the uterine cavity was opened, until the end of delivery. Compare the rates of oxytocin use, uterine dilatation and the number of times the epidural self-controlled analgesia pump is pressed during the first and second stages of labor, delivery methods, newborn body weight, umbilical blood pH, and min and 5 min Apgar scores, VAS scores during maternal repair of the perineum, and maternal satisfaction scores for analgesia in the second stage of labor. Results: There was no significant difference in the use rate of oxytocin, dilatation of the uterine orifice and the number of times of pressing the epidural self-controlled analgesia pump in the first and second stages of labor, the method of delivery(cesarean delivery, device assisted delivery,natural delivery rate), analgesia time in the first stage of labor, and first and second stage of labor between the two groups(P>0.05). There was no significant difference in body weight, umbilical artery blood pH value, and the proportion of newborns with Apgar scores less than 8 in 1 min and 5 min after birth between the two groups(P>0.05). The VAS score of the observation group when repairing the perineum was significantly lower than that of the control group(P<0.05), and the satisfaction score of the women during the second stage of labor the observation group was significantly higher than that of the control group(P<0.05). Conclusion: Continuous analgesic delivery has no significant effect on maternal delivery outcome and neonatal scores, but it can significantly increase maternal satisfaction with analgesia in the second stage of labor and with analgesia when repairing the perineum.