腰硬联合阻滞镇痛联合气囊仿生技术助产在剖宫产术后瘢痕子宫再次妊娠产妇经阴道试产中的应用

Application of combined spinal-epidural analgesia plus balloon bionic midwifery technology to vaginal delivery trial in scarred uterus parturients with second pregnancy after cesarean section

目的观察腰硬联合阻滞镇痛联合气囊仿生技术助产在剖宫产术后瘢痕子宫再次妊娠产妇经阴道试产中的应用效果。方法回顾性分析100例剖宫产术后瘢痕子宫再次妊娠产妇的临床资料,其中50例采用腰硬联合阻滞镇痛联合气囊仿生技术助产经阴道试产(观察组),另50例仅采用气囊仿生技术助产经阴道试产(对照组)。观察两组产妇的总产程、剖宫产率、新生儿窒息发生率、产后2 h出血量、产后出血率、先兆子宫破裂发生率、分娩时产妇疼痛视觉模拟量表(VAS)评分。结果两组产妇的剖宫产、先兆子宫破裂、产后出血、新生儿窒息发生率比较,差异均无统计学意义(均P>0.05),但观察组总产程短于对照组,分娩时VAS评分低于对照组,产后2 h出血量少于对照组(均P<0.05)。结论剖宫产术后瘢痕子宫再次妊娠产妇经阴道试产时采用腰硬联合阻滞镇痛联合气囊仿生技术助产,能够缩短产程,减少产后出血量和产妇疼痛感,母婴安全性高。

Objective To observe the effect of combined spinal-epidural analgesia plus balloon bionic midwifery technology applied to vaginal delivery trial in scarred uterus parturients with second pregnancy after cesarean section.Methods The clinical data of 100 scarred uterus parturients with second pregnancy after cesarean section were analyzed retrospectively.Among them,50 cases applied combined spinal-epidural analgesia plus balloon bionic midwifery technology to vaginal delivery trial(observation group),and another 50 cases only applied balloon bionic midwifery technology to vaginal delivery trial(control group).The related indices of parturients were observed in the two groups,including total labor duration,cesarean section rate,incidence rate of neonatal asphyxia,2-hour postpartum hemorrhage volume,postpartum hemorrhage rate,incidence rate of threatened rupture of uterus,and maternal Visual Analogue Scale(VAS)pain score during childbirth.Results No statistically significant difference was found between the two groups in incidence rate of maternal cesarean section,threatened rupture of uterus,postpartum hemorrhage or neonatal asphyxia(all P>0.05).However,the observation group exhibited shorter total labor duration,lower VAS score at delivery,and less 2-hour postpartum hemorrhage volume as compared with the control group(all P<0.05).Conclusion For scarred uterus parturients with second pregnancy after cesarean section,in vaginal delivery trial,the use of combined spinal-epidural analgesia plus balloon bionic midwifery technology can reduce labor duration,diminish postpartum hemorrhage volume and ameliorate parturients′pain,achieving a higher maternal and neonatal safety.