欣普贝生和间苯三酚联合运用在足月孕产妇无痛分娩引产中的应用观察

Application of dinoprostone and phloroglucinol in painless delivery in full-term pregnancy patients

目的初步探讨在分娩镇痛条件下足月妊娠引产中联用欣普贝生、间苯三酚的效果。方法选取2016年10月至2018年10月于廊坊市妇幼保健中心就诊的需足月妊娠引产、单胎、无内外科合并症,无产科禁忌症、无前列腺素应用禁忌症、无麻醉禁忌症、宫颈bishop评分≤6分的初产妇共100例,通过随机数字表法,分为观察组与对照组两组,每组50例。对照组采取缩宫素静脉滴注法引产,宫口开大3 cm时进行硬膜外阻滞麻醉技术分娩镇痛;观察组运用欣普贝生阴道放置及间苯三酚静脉推注的方法,宫口开大3 cm时进行硬膜外阻滞麻醉技术分娩镇痛。比较两组促宫颈成熟有效率、引产效率、具体产程、疼痛程度及妊娠结局等。结果观察组孕产妇(94.00%)促宫颈成熟有效率明显高于对照组(76.00%),差异具有统计学意义(P<0.05)。两组孕产妇疼痛程度比较结果显示:I级疼痛观察组36例(72.00%),明显高于对照组24例(48.00%);III级疼痛观察组2例(4.00%),明显低于对照组8例(16.00%);II级疼痛两组孕产妇差异无统计学意义(P>0.05)。观察组引产成功46例(92.00%),对照组引产成功38例(76.00%),观察组引产成功率明显高于对照组,差异具有统计学意义(P<0.05)。观察组潜伏期、活跃期、第一产程及总产程时长明显短于对照组,差异具有统计学意义(P<0.05);两组孕产妇第二产程、第三产程时长差异无统计学意义(P>0.05)。两组孕产妇新生儿窒息率、Apgar评分及产后出血量比较差异无统计学意义(P>0.05)。结论在分娩镇痛条件下使用欣普贝生阴道放置及间苯三酚静脉推注引产成功率明显优于缩宫素静脉点滴。

Objective To investigate the specific effects of combined use of dinoprostone and phloroglucinol in painless delivery in full-term pregnant patients.Methods 100 primiparas admitted from Oct.2016 to Oct.2018 in our hospital were enrolled in this study.The 100 primiparas all met the following conditions:full-term pregnancy induced labor,singletons,no local complications,no maternity contraindications,no prostaglandins contraindications,no anesthesia contraindications and bishop scores of cervical were six points or less.By using the random number table method,they were divided into observation group and control group in the two groups,50 cases in each group.Patients in the control group were induced labor by intravenous oxytocin infusion,and labor analgesia was performed under anesthesia when the opening of uterine orifice was 3 cm.In the observation group,labor induction mode was changed on the basis of the control group.Dinoprostone was used to induce labor at the posterior vaginal vault of the patient,and intravenous infusion of phloroglucinol was performed when the opening of uterine orifice was 3 cm and labor analgesia was performed under anesthesia.The cervical maturation rate,labor induction rate,specific labor process,pain degree and pregnancy outcome were compared between the two groups.Results The effective rate of cervical maturation in the observation group(94.00%)was significantly higher than that in the control group(76.00%),and the difference was statistically significant(P<0.05).The comparison results of pain degree between the two groups showed that:36 cases(72.00%)with grade I pain in the observation group,significantly higher than 24 cases(48.00%)of the control group,and 2 cases(4.00%)with grade III pain in the observation group,significantly lower than 8 cases(16.00%)in the control group,with statistically significant differences(P<0.05).There was no significant difference between the two groups in term of the number of patients with grade II pain patients(P>0.05).There were 46 cases(92.00%)of successful labor induction in the observation group and 38 cases(76.00%)in the control group.The success rate of labor induction in the observation group was significantly higher than that in the control group,with statistically significant difference(P<0.05).The incubation period,active period,first stage and total length of labor in the observation group were significantly shorter than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in the length of the second and third stages of labor between the two groups(P>0.05).There was no significant difference in neonatal asphyxia rate,Apgar score and postpartum blood loss between the two groups(P>0.05).Conclusion The application of dinoprostone in painless delivery can effectively shorten the length of labor,and has a good effect on pain relief and smooth delivery,which can further accelerate the labor process of patients,accelerate cervical maturation,soften the cervix of patients,reduce spasm,and improve the rate of labor induction by combining with phloroglucinol,with more accurate efficacy.