硬膜外麻醉分娩镇痛对初产妇分娩质量及盆底肌功能的影响

EFFECT OF EPIDURAL ANESTHESIA ON DELIVERY QUALITY AND PELVIC FLOOR MUSCLE FUNCTION OF PRIMIPARA

目的分析硬膜外麻醉分娩镇痛对初产妇分娩质量及盆底肌功能的影响。方法将2018年1月—2019年11月本院100例采取硬膜外麻醉分娩镇痛产妇作为观察组,以孕周、身体质量指数作为匹配因素,按照1∶1配比选择100例自然待产及分娩初产妇为对照组。比较分娩方式、母婴结局、产痛情况及产后复查时盆底功能。结果观察组中途转剖宫产率为20.00%,低于对照组的33.00%;观察组产痛分级主要集中于0级、1级,明显优于对照组,差异有统计学意义(P<0.05)。观察组第二产程时间为(62.15±12.45)min,对照组为(48.45±14.11)min,差异有统计学意义(P<0.05);观察组产后42 d时盆底肌力(3.24±0.34)%高于对照组的(2.45±0.27)%,差异有统计学意义(P<0.05),但Ⅰ类肌纤维疲劳度、Ⅱ类肌纤维疲劳度比较,差异无统计学意义(P>0.05)。结论初产妇在规律宫缩后应用硬膜外麻醉分娩镇痛能提高阴道分娩率,不引起不良母婴结局,且可一定程度上减轻盆底肌的损伤程度。

Objective To analyze the effect of epidural anesthesia on delivery quality and pelvic floor muscle function of primipara.Methods From January 2018 to November 2019,one hundred cases of parturient undergoing epidural anesthesia for labor analgesia in The Second People′s Hospital of Hefei were selected as the observation group,with gestational weeks and body mass index as matching factors,and 100 cases of natural expectant and primiparas were selected as the control group according to the ratio of 1:1.Methods of delivery,maternal and infant outcomes,labor pain and pelvic floor function were compared.Results The cesarean section rate in the observation group was 20.00%,which was lower than 33.00%of the control group;the labor pain grading of the observation group was mainly concentrated in grade 0 and grade 1,which was significantly better than that in the control group(P<0.05).The second stage of labor was(62.15±12.45)min in the observation group and(48.45±14.11)min in the control group,the difference was statistically significant(P<0.05);the pelvic floor muscle strength in the observation group at 42 d after delivery(3.24±0.34)%was higher than that in the control group(2.45±0.27)%,the difference was statistically significant(P<0.05),but there was no significant difference in the fatigue degree of type I muscle fiber and type II muscle fiber(P>0.05).Conclusion Epidural analgesia for labor analgesia after regular uterine contraction can improve the vaginal delivery rate of primiparas,and not cause adverse maternal-infant outcomes,and can reduce the injury of pelvic floor muscle to a certain extent.