不同时机实施腰-硬联合镇痛在初产妇无痛分娩中的对比研究

Comparative research on the application of combined spinal-epidural analgesia at different times in painless delivery of primiparas

目的探讨不同时机实施腰-硬联合镇痛在初产妇无痛分娩中的应用价值。方法将2019年2月至2020年10月在广东省农垦中心医院行无痛分娩初产妇100例随机分为对照组和观察组。对照组(50例)在宫口≥3 cm时行腰-硬联合镇痛,观察组(50例)则在宫口<3 cm时行腰-硬联合镇痛。比较两组的疼痛程度、产程时间、中转剖腹产情况、新生儿指标和满意度。结果观察组第一产程潜伏期和第一产程活跃期的视觉模拟评分法评分明显低于对照组(P<0.05)。两组产程时间,中转剖腹产构成比,新生儿的Apgar评分、血氧饱和度和呼吸频率比较,差异均无统计学意义(P>0.05)。观察组产妇和家属的满意度明显高于对照组(P<0.05)。结论在宫口<3 cm时行腰-硬联合镇痛可明显减轻第一产程的疼痛程度,提高初产妇及家属的满意度,并且不影响产程和新生儿的健康。

Objective To investigate the application value of combined spinal-epidural analgesia at different times in painless delivery of primiparas.Methods A total of 100 primiparas undergoing painless delivery in Guangdong Agricultural Reclamation Central Hospital from February 2019 to October 2020 were randomly divided into the control group and the observation group.Patients in the control group(n=50)were given combined spinal-epidural analgesia when the uterine orifice was≥3 cm,while those in the observation group(n=50)were given combined spinal-epidural analgesia when the uterine orifice was<3 cm.The pain degree,labor time,conversion to caesarean section,neonatal index and satisfaction were compared between the two groups.Results The visual analogue scale scores of the observation group during the latent period and active period of the first stage of labor were significantly lower than those of the control group(P<0.05).There were no statistically significant differences in labor time,constituent ratio of converted caesarean section,neonatal Apgar score,blood oxygen saturation and respiratory rate between the two groups(P>0.05).The satisfaction of maternal and their families in the observation group was significantly higher than that in the control group(P<0.05).Conclusion When the uterine orifice is<3 cm,combined spinal epidural analgesia can obviously reduce the pain degree of the first stage of labor,improve the satisfaction of primiparas and their families,and does not impact the labor and health of the neonate.