全产程分娩镇痛对妊娠期高血压综合征患者产程进展及分娩方式的影响

Effect of Full-term Labor Analgesia on Labor Progress and Delivery Methods in Patients with Pregnancy-induced Hypertension Syndrome

目的探讨全产程分娩镇痛在妊娠期高血压综合征患者中的应用效果。方法回顾性分析2018年1月—2019年7月在该院分娩的90例妊娠期高血压综合征患者的临床资料,根据分娩镇痛方式的不同分为对照组(45例,第一产程分娩镇痛)和观察组(45例,全产程分娩镇痛),比较两组疼痛情况、产程进展、分娩情况、新生儿状况及分娩方式。结果两组镇痛前、镇痛10 min后及宫口开全时疼痛评分对比,差异无统计学意义(P>0.05);观察组第二产程屏气用力时与胎头娩出时疼痛评分依次为(2.28±0.52)分、(2.59±0.84)分,低于对照组(5.19±1.02)分、(5.31±1.17)分,差异有统计学意义(t=17.050、12.668,P=0.000)。两组第一、二、三产程及总产程时间对比,均差异无统计学意义(P>0.05);两组应用缩宫素、降压治疗、产后出血占比对比,均差异无统计学意义(P>0.05);两组新生儿Apgar评分、动脉血pH值、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、剩余碱(BE)值对比,差异无统计学意义(P>0.05);两组分娩方式对比,差异无统计学意义(P>0.05)。结论全产程分娩镇痛在妊娠期高血压综合征产妇中应用效果较好,对产程进展及分娩结局的影响均较为轻微,并可帮助产妇减轻分娩全程疼痛程度,具有较高的安全性与有效性。

Objective To investigate the effect of full-course labor analgesia in patients with pregnancy-induced hypertension syndrome. Methods The clinical data of 90 patients with pregnancy-induced hypertension syndrome delivered in the hospital from January 2018 to July 2019 were retrospectively analyzed. They were divided into the control group(45 cases, delivery in the first stage of labor) and observation group(45 cases, full-time labor analgesia)according to the different analgesia methods of delivery, compared the pain, progress of labor, delivery, neonatal status and delivery method in the two groups. Results There was no significant difference in pain scores between the two groups before analgesia, 10 minutes after analgesia, and full-time uterine opening(P >0.05). The pain scores of the observation group during the second stage of holding breath and exerting force were the order of(2.28±0.52)points and(2.59±0.84) points, which were lower than the control group(5.19±1.02)points and(5.31±1.17) points. The difference was statistically significant(t=17.050, 12.668, P=0.000). There was no statistically significant difference in the first,second and third stages of labor and total labor time between the two groups(P >0.05). There was no statistically significant difference in the proportion of oxytocin, antihypertensive therapy and postpartum hemorrhage in the two groups.(P>0.05);Apgar score, arterial blood pH value, arterial blood carbon dioxide partial pressure(PaCO2), arterial blood oxygen partial pressure(PaO2), and residual alkali(BE) values of the two groups of newborns were not statistically significantly different(P>0.05);there was no statistically significant difference between the two modes of delivery(P>0.05). Conclusion The full-partum labor analgesia has a good application effect in pregnant women with pregnancy-induced hypertension syndrome, and has a slight impact on the progress of labor and the outcome of childbirth. It can help the mother to alleviate the pain during labor and has high safety and effectiveness.