椎管内麻醉分娩镇痛对产程和分娩结果影响的临床价值

Clinical Value of Intraspinal Anesthesia for Labor Analgesia on Labor Process and Labor Outcome

目的探讨对产妇给予椎管内麻醉分娩镇痛干预后对其分娩结果以及产程产生的影响。方法选取肇庆市第二人民医院2018年1月至2019年2月收治的90例产妇为研究对象,按照数字奇偶法分为干预组和对照组,各45例。干预组选择椎管内麻醉分娩镇痛方式展开分娩干预;对照组未选择麻醉镇痛方式展开分娩干预;比较2组产妇不同产程视觉评分表(VAS)、产后失血量、总产程时间、新生儿阿氏评分(Apgar)以及新生儿结局(新生儿肺炎、呼吸窘迫综合征、自然分娩)。结果干预组产妇第一产程VAS评分(2.59±1.13)分、第二产程VAS评分(3.59±1.15)分、产后失血量(203.59±46.25)mL、总产程时间(480.13±26.49)min,少于对照组(6.78±2.53)分、(5.13±1.59)分、(273.49±52.59)mL、(540.79±36.39)min;干预组新生儿Apgar评分(8.31±1.53)分高于对照组(7.40±1.26)分,差异有统计学意义(P<0.05);干预组产妇新生儿肺炎发生率2.22%以及呼吸窘迫综合征发生率2.22%低于对照组20.00%和17.78%(P<0.05);干预组自然分娩发生率88.89%高于对照组55.56%(P<0.05)。结论椎管内麻醉分娩镇痛方式的有效运用,可实现产妇分娩疼痛感缓解,产后失血量减少,总产程时间缩短,新生儿Apgar评分提升以及新生儿结局改善,最终发现产妇预后水平显著提升。

Objective To investigate the effect of analgesic intervention with intraspinal anesthesia on the outcome and duration of labor.Methods A total of 90 cases of parturients admitted to Zhaoqing Second People's Hospital from January 2018 to February 2019 were selected as the research objects.The digital parity method was divided into intervention group and control group,each with 45 cases.In the intervention group,intraspinal anesthesia delivery analgesia was selected to carry out delivery intervention;in the control group,anesthesia analgesia was not selected to carry out delivery intervention;the visual scale of different stages of labor(VAS),postpartum blood loss,total duration of labor,Apgar and neonatal outcome(neonatal pneumonia,respiratory distress syndrome,natural delivery)were compared among the groups.Results The VAS score of the first stage of labor,the VAS score of the second stage of labor,the postpartum blood loss and the total time of labor in the intervention group were(2.59±1.13),(3.59±1.15),(203.59±46.25)mL,(480.13±26.49)min,respectively,lower than those in the control group(6.78±2.53),(5.13±1.59),(273.49±52.59)mL,(540.79±36.39)min.The Apgar score of the intervention group(8.31±1.53)was higher than that of the control group(7.40±1.26),the difference was statistically significant(P<0.05)。The incidence of neonatal pneumonia and respiratory distress syndrome in the intervention group were 2.22%and 2.22%respectively lower than that in the control group 20.00%and17.78%,(P<0.05).The incidence of spontaneous delivery in the intervention group was 88.89%higher than that in the control group 55.56%(P<0.05).Conclusion The effective use of intraspinal anesthesia for labor analgesia can alleviate labor pain,reduce postpartum blood loss,shorten total labor time,improve Apgar score and improve neonatal outcome,and finally,the prognosis of obstetric women is significantly improved.