硬膜外麻醉分娩镇痛对初产妇产后母乳喂养及盆底功能的影响

The effect of epidural analgesia during labor on postpartum breastfeeding and pelvic floor function in primiparas

目的研究硬膜外麻醉分娩镇痛对初产妇产后母乳喂养及盆底功能的影响。方法选择我院2017年1月至2019年12月入院的初产妇120例作为研究对象,根据给予患者麻醉镇痛方法不同将其分成芬太尼组、舒芬太尼组及无分娩镇痛组,每组各40例。对比三组产妇的母乳喂养情况、泌乳初始时间及新生儿72 h内的添奶次数以及盆底功能。结果舒芬太尼组初产妇的母乳喂养率为62.5%(25/40),芬太尼组产妇的母乳喂养率为45%(18/40),无分娩镇痛组母乳喂养率为30.0%(12/40),舒芬太尼组高于芬太尼组及无分娩镇痛组,差异有统计学意义(P=0.001、0.004);舒芬太尼组泌乳初始时间及新生儿72 h内添奶次数高于芬太尼组及无分娩镇痛组;舒芬太尼组初产妇的盆底功能各项指标高于芬太尼组及无分娩镇痛组,差异均有统计学意义(P<0.05)。结论初产妇分娩之后给予其硬膜外麻醉分娩镇痛的措施,可提升产妇的母乳喂养率,促使产妇逐渐分泌母乳,且不会对产妇的盆底功能造成严重影响,值得临床推广。

Objective To study the effect of epidural analgesia during labor on postpartum breastfeeding and pelvic floor function of primiparas.Methods A total of 120 primiparas admitted to our hospital from January 2017 to December 2019 were selected as the research objects.According to the different anesthesia and analgesia methods,they were divided into the fentanyl group,sufentanil group,and non-delivery analgesia group,with 40 cases in each group.The breastfeeding status,the initial time of lactation,the number of feedings within 72 hours of the newborn,and the pelvic floor function of the three groups were compared.Results The breastfeeding rate of primiparas was 62.5%(25/40)in the sufentanil group,45.0%(18/40)in the fentanyl group,and 30.0%(12/40)in the non-labor analgesia group.The breastfeeding rate of the sufentanil group was higher than that of the fentanyl group and the non-labor analgesia group,and the difference was statistically significant(P=0.001,0.004).The initial lactation time and the number of infant feedings of newborns within 72 hours in the sufentanil group were higher than those of the fentanyl group and the non-labor analgesia group.The pelvic floor function indexes of the primiparas in the sufentanil group were higher than those of the fentanyl group and the non-labor analgesia group,showed that the differences were statistically significant(P<0.05).Conclusion Epidural analgesia after delivery given to primiparas can increase the breastfeeding rate of the mothers,promote the gradual secretion of breast milk,and will not seriously affect the pelvic floor function of the mothers.It is worthy of clinical promotion.