硬膜外麻醉对初产妇分娩疼痛程度、产程进展及分娩结局的影响

Effect of Epidural Anesthesia on Labor Pain,Labor Progress and Delivery Outcome in Primipara

目的观察硬膜外麻醉对初产妇分娩疼痛程度、产程进展及分娩结局的影响。方法选取2020年6月-2021年6月在我院分娩的104例初产妇为研究对象,采用随机数字表法分为对照组和观察组,各52例。对照组常规自然分娩,观察组实施硬膜外麻醉无痛分娩。比较两组分娩方式、各产程时间、产中和产后24h疼痛评分(VAS)、母婴分娩并发症发生情况。结果观察组阴道自然分娩率高于对照组,剖宫产分娩率低于对照组,第一、第二产程时间短于对照组(P<0.05);两组阴道助产分娩率及第三产程时间比较,差异无统计学意义(P>0.05);观察组产中及产后24h疼痛评分、胎儿窘迫发生率、新生儿窒息发生率、产妇宫颈裂伤及会阴损伤发生率均低于对照组(P<0.05);两组产后出血、尿潴留比较,差异无统计学意义(P>0.05)。结论硬膜外麻醉可促进初产妇产程进展,缩短第一、第二产程时间,减轻分娩疼痛,降低剖宫产率、母婴不良分娩并发症。

Objective To observe the effect of epidural anesthesia on labor pain,labor progress and labor outcome of primipara.Methods A total of 104 primiparas who delivered in our hospital from June 2020 to June 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 52 cases in each group.The control group received routine natural childbirth,and the observation group received epidural anesthesia for painless childbirth.The mode of delivery,the duration of each stage of labor,the 24-hour pain score(VAS)during and after delivery,and the incidence of maternal and infant delivery complications were compared between the two groups.Results The vaginal natural delivery rate in the observation group was higher than that in the control group,the cesarean delivery rate was lower than that in the control group,and the first and second stages of labor were shorter than those in the control group(P<0.05).There was no significant difference in vaginal delivery rate and the third stage of labor between the two groups(P>0.05).The pain score of intrapartum and postpartum 24 h,the incidence of fetal distress,the incidence of neonatal asphyxia,the incidence of cervical laceration and perineal injury in the observation group were lower than those in the control group(P<0.05).There was no significant difference in postpartum hemorrhage and urinary retention between the two groups(P>0.05).Conclusion Epidural anesthesia can promote the progress of labor in primipara,shorten the first and second labor time,reduce labor pain,reduce cesarean section rate and maternal and infant complications.