硬膜外自控镇痛辅以自由体位对初产妇产程及分娩结局的影响

Effect of Patient-controlled Epidural Analgesia with Free Position on Labor Process and Delivery Outcome in Primipara

【目的】分析硬膜外自控镇痛辅以自由体位对初产妇产程与分娩结局的影响。【方法】选取2020年1月至2020年12月250例待产的初产孕妇,按照随机数字表法分为对照组和观察组,每组125例。对照组行硬膜外自控镇痛+传统体位分娩,观察组行硬膜外自控镇痛+自由体位分娩,比较两组产程、住院时间、产后2h出血量、分娩结局、产后盆底功能、分娩疼痛视觉模拟评分(VAS)及腰酸改善情况。【结果】观察组患者各产程耗时、VAS评分、产后2h出血量及会阴侧切率、中转剖宫产率、产钳助产率、产后出血率均低于对照组(P<0.05)。两组住院时间和新生儿窒息发生率比较差异无统计学意义(P>0.05)。观察组患者产后6周VRP、VSP、Ⅰ类纤维强度、Ⅱ类纤维强度及腰酸改善率均高于对照组,收缩持续时间长于对照组,差异均有统计学意义(P<0.05)。【结论】与常规平卧位相比,硬膜外自控镇痛+自由体位分娩可缓解减轻初产妇分娩疼痛、缩短初产妇产程,缓解分娩疼痛,改善分娩结局,促进盆底功能恢复。

【Objective】To explore the effects of patient-controlled epidural analgesia plus free position on primary maternal labor process and delivery outcomes.【Methods】A total of 250 primiparous pregnant women who met the requirements in our hospital from January 2020 to December 2020 were selected and divided into the control and the observation groups using the random number table method,with 125 cases in each group.The control group received patient-controlled epidural analgesia+traditional position delivery,wile the observation group received patient-controlled epidural analgesia+free position delivery.The duration of labor,length of hospital stay,2-hour postpartum hemorrhage,delivery outcome,postpartum pelvic floor function,visual analog scale(VAS)score for delivery pain and condition of lumbar acid were compared between the two groups.【Results】The duration of labor,VAS score,2-hour postpartum blood loss,perineal lateral resection rate,cesarean section rate,forceps delivery rate,postpartum bleeding rate in the observation group were lower than those in the control group(P<0.05).There were no differences in the length of hospital stay and incidence of neonatal asphyxia between the two groups(P>0.05).The amount of 2H postpartum haemorrhage in the observation group patients was lower than that in the control group(P<0.05).Patients in the observation group had higher VRP,VSP,fiber strength classⅠ,and fiber strength classⅡat 6 weeks postpartum compared to the control group,and the duration of contractions was longer than the control group as well(P<0.05).Patients in the observation group had lower VAS scores at delivery compared to the control group,whereas improvement in lumbar acid was better(P<0.05).【Conclusion】Compared with the conventional lying flat position,patient-controlled epidural analgesia with free position delivery can relieve labor pain,shorten labor process,relieve pain,improve delivery outcome,and promote pelvic floor function recovery.