硬膜外分娩镇痛对初产妇产时发热的影响因素分析

Analysis of the influencing factors of fever during the labor in primipara with epidural labor analgesia

目的分析硬膜外分娩镇痛对初产妇产时发热的影响因素。方法选择2019年10月至2020年10月于我院产科分娩的105名初产妇作为研究对象,根据鼓膜体温测量结果将其分为发热组和正常组,组间行初产妇产时发热的单因素分析,对单因素分析中有统计学意义的因素进一步行Logistic多因素分析。结果单因素分析结果显示,发热组BMI及产前抑郁、产前焦虑、羊水污染、使用缩宫素、连续硬膜外镇痛给药初产妇占比高于正常组,胎膜破裂至分娩结束时间、产程、分娩镇痛时间长于正常组(P<0.05)。Logistic多因素分析结果显示,BMI、胎膜破裂至分娩结束时间、产程、分娩镇痛时间、缩宫素使用、硬膜外镇痛给药方式是影响初产妇产时发热的独立危险因素(P<0.05)。结论BMI过高、胎膜破裂至分娩结束时间、产程及分娩镇痛时间过长、使用缩宫素、连续硬膜外镇痛给药是影响初产妇产时发热的独立危险因素,针对上述影响因素临床应及时干预。

Objective To analyze the influencing factors of fever during the labor in primipara with epidural labor analgesia.Methods A total of 105 primiparas delivered in obstetrics department of our hospital from October 2019 to October 2020 were selected as the research objects.According to the results of tympanic membrane thermometry,the primiparas were divided into fever group and normal group.The single factor analysis of fever during the labor in primipara was conducted between the two groups.Logistic multivariate analysis was carried out for the factors with statistical significance in single factor analysis.Results The single factor analysis result showed that BMI and the proportion of primiparas with prenatal depression,prenatal anxiety,amniotic fluid pollution,use of oxytocin,continuous epidural analgesia in the fever group were higher than those in the normal group,the time from rupture of fetal membrane to the end of labor,labor process and labor analgesia time in the fever group were longer than those in the normal group(P<0.05).Logistic multivariate analysis result showed that BMI,the time from rupture of fetal membrane to the end of labor,labor process,labor analgesia time,oxytocin use and administration mode of epidural analgesia were independent risk factors for fever during the labor in the primiparas(P<0.05).Conclusion The high BMI,the long time from rupture of fetal membrane to the end of labor,long labor process and long labor analgesia time,use of oxytocin,continuous epidural analgesia is the independent risk factors of fever during the labor of primipara,clinical intervention should be timely carried out according to the above factors.