不同宫口扩张长度行分娩镇痛在初产妇分娩中应用分析

Application of Labor Analgesia with Different Length of Dilated Uterine Orifice in Delivery of Primipara

目的:探讨不同宫口扩张长度行分娩镇痛在初产妇分娩中的应用效果。方法:选取2018年8月-2020年8月在本院分娩的200例初产妇作为研究对象,根据是否行分娩镇痛分为观察组(n=136,行分娩镇痛)和对照组(n=64,未行分娩镇痛),观察组再根据临床行分娩镇痛时的宫口扩张长度不同分为观察一组(n=69,宫口扩张<3 cm)与观察二组(n=67,宫口扩张≥3 cm)。比较三组第一产程、第二产程、第三产程、总产程时间,镇痛药物使用量,疼痛评分,催产素使用率,催产素使用量,中转剖宫产率,产后出血量,新生儿1 min Apgar评分。结果:观察一、二组第一产程和第二产程、总产程时间均长于对照组,差异均有统计学意义(P<0.05)。观察一组镇痛药物使用量高于观察二组,观察一、二组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察一、二组催产素使用率和催产素使用量均高于对照组(P<0.05)。观察一组催产素使用量高于观察二组(P<0.05)。观察一组中转剖宫产率高于对照组(P<0.05)。三组新生儿1 min Apgar评分比较,差异无统计学意义(P>0.05)。结论:在初产妇分娩中,宫口扩张≥3 cm时行分娩镇痛会增加总产程时间、镇痛药物及催产素的使用,但能有效降低初产妇的疼痛程度,且对中转剖宫产率和母婴预后没有影响,为较合适的分娩镇痛时机,同时应结合不同初产妇的个人情况,选择最佳的镇痛时机。

Objective:To investigate the application effect of labor analgesia with different length of dilated uterine orifice in the delivery of primipara.Method:A total of 200 primiparas who delivered in our hospital from August 2018 to August 2020 were selected as the research subjects,they were divided into the observation group (n=136,labor analgesia was applied) and the control group (n=64,no labor analgesia was applied) according to whether labor analgesiaperformed,and then the observation group was divided into the observation 1 group (n=69,dilationof uterine orifice <3 cm) and the observation 2 group (n=67,dilation of uterine orifice ≥3 cm).The first stage of labor,second stage of labor,third stage of labor,total stage of labor time,analgesic drug use,pain scores,Oxytocin use rates,Oxytocin use,conversion rates of cesarean section,amount of postpartum hemorrhage,neonatal 1 min Apgar scores among three groups were compared.Result:The first stage of labor,the second stage of labor and total stage of labor times in the observation 1 and 2 group were longer than those in the control group,and the differences were statistically significant (P<0.05).The dosage of analgesic drugs in the observation 1 group was higher than that in the observation 2 group,and the VAS scores of the observation 1 and 2 group were lower than that in the control group,and the differences were statistically significant (P<0.05).The use rates and amount of Oxytocin in the observation 1 and 2 group were higher than those in the control group (P<0.05).The dosage of Oxytocin in the observation 1 group was significantly higher than that in the observation 2 group (P<0.05).The rate of conversion to cesarean section in the observation 1 group was significantly higher than that in the control group (P<0.05).There was no significant difference in 1 min Apgar score among three groups (P>0.05).Conclusion:In the delivery of primiparas,labor analgesia when the length of dilated uterine orifice is ≥3 cm will increase the total labor duration,the use rate and the amount of Oxytocin,but it can effectively reduce the pain degree of primipara,and has no effect on the cesarean section rate and the prognosis of mother and infant.It is a more appropriate time for labor analgesia,at the same time,it should be combined with the personal conditions of different primipara to choose the best time for analgesia.