全产程与第一产程分娩镇痛在妊娠期高血压产妇中的应用效果比较

Comparison of effect of whole labor analgesia versus first labor analgesia on labor process of women with gestational hypertension

目的比较全产程分娩镇痛与第一产程分娩镇痛在妊娠期高血压产妇中的应用效果。方法抽取2017年12月至2019年12月于山西省中西医结合医院分娩的妊娠期高血压产妇150例,按照双盲法将其随机分为两组,每组75例。对照组实施第一产程分娩镇痛,研究组实施全产程分娩镇痛。比较两组产妇各产程时间、不同产程视觉模拟量表(VAS)评分、分娩方式及新生儿Apgar评分。结果两组第一、二、三产程时间比较,差异未见统计学意义(P>0.05)。第一产程潜伏期研究组VAS评分低于对照组(P<0.05),第一产程活跃期、第二产程及第三产程两组VAS评分比较差异未见统计学意义(P>0.05)。对照组自然分娩、产钳助产及剖宫产发生率分别为73.34%(55/75)、13.33%(10/75)、13.33%(10/75),研究组相应值分别为78.66%(59/75)、10.67%(8/75)、10.67%(8/75)。两组分娩方式、新生儿Apgar评分比较差异未见统计学意义(P>0.05)。结论两种分娩镇痛方法均可有效缓解分娩疼痛,全产程分娩镇痛可减轻第一产程早期时间段的疼痛程度,对产程时间、分娩方式及胎儿健康无明显影响。

Objective To compare the effect of whole labor analgesia and first labor analgesia on labor process of women with gestational hypertension.Methods A total of 150 women with gestational hypertension in Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from December 2017 to December 2019 were enrolled,and they were divided into two groups by random number table,with 75 cases in each group.Control group received first labor analgesia,while study group received whole labor analgesia.The labor time,visual analog scales(VAS)scores of different labor stages,delivery modes and neonatal Apgar score were compared between the two groups.Results There were no significant differences in the first,second,and third labor time between the two groups(P>0.05).VAS score of first labor early stage in the study group was lower than that in the control group(P<0.05),VAS score of fist labor late stage,second labor stage and third labor stage had no significant differences between the two groups(P>0.05).The incidences of natural delivery,forceps delivery and cesarean section in the control group were 73.34%(55/75),13.33%(10/75)and 13.33%(10/75),respectively,and the corresponding values in the study group were 78.66%(59/75),10.67%(8/75)and 10.67%(8/75),respectively.Neonatal Apgar score and delivery modes had no significant differences between the two groups(P>0.05).Conclusions Both modes of labor analgesia can effectively relieve labor pain,whole labor analgesia can effectively reduce the pain of pregnant women with gestational hypertension during the early stage of first labor,and it has no obvious effect on labor time,delivery mode and fetal health.