程控硬膜外脉冲式注射在初产妇硬膜外分娩镇痛中的应用

Application of Programmed Epidural Pulse Injection in Epidural Labor Analgesia for Primipara

目的探讨程控硬膜外脉冲式注射在初产妇硬膜外分娩镇痛中的临床应用价值。方法方便选择2020年3月—2021年12月淄博市妇幼保健院收治的住院分娩待产初产妇80名,按随机数字法分为两组,各40名。观察组进行程控脉冲给药,对照组实施常规硬膜外持续输注给药,比较两组分娩结局情况、产程相关时间、新生儿Apgar评分、围生期母婴相关并发症情况。结果观察组阴道分娩率高于对照组,剖宫产率低于对照组,差异有统计学意义(P<0.05);观察组第一产程和第二产程时间分别为(5.2±0.8)h和(0.8±0.1)h,显著短于对照组的(8.9±1.2)h和(1.4±0.3)h,差异有统计学意义(t=16.226、12.000,P<0.05),观察组1 min和5 min的Apgar评分分别为(9.1±0.2)分和(9.5±0.1)分,均高于对照组的(7.2±0.7)分和(8.1±0.6)分,差异有统计学意义(t=16.506、14.557,P<0.05),观察组产后大出血和产道损伤总发生率低于对照组,差异有统计学意义(P<0.05)。结论针对初产妇分娩镇痛实施程控硬膜外脉冲式注射,能有效提高经阴道分娩率,缩短产程,减少并发症,提高分娩镇痛治疗安全性。

Objective To explore the clinical application value of programmed epidural pulse injection in epidural labor analgesia for primiparas.Methods 80 hospitalized primipara from March 2020 to December 2021 admitted in Zibo Maternal and Child Hospital were conveniently selected,and they were randomly divided into two group,40 primipara in each group.The observation group was given program-controlled pulse administration,the control group was given routine epidural continuous infusion administration,and the delivery outcomes,the labor-related time and neonatal Apgar,the perinatal maternal and infant-related complications were compared between the two groups.Results The vaginal delivery rate in the observation group was higher than that in the control group,and the cesarean section rate was lower than that in the control group,the difference was statistically significant(P<0.05).The time of the first stage of labor and the second stage of labor in the observation group were(5.2±0.8)h and(0.8±0.1)h,which were significantly shorter than those in the control group(8.9±1.2)h and(1.4±0.3)h,the difference was statistically significant(t=16.226,12.000,P<0.05).The Apgar scores of the observation group at 1 min and 5 min were(9.1±0.2)points and(9.5±0.1)points,respectively,which were higher than those of the control group(7.2±0.7)points and(8.1±0.6)points,the difference was statistically significant(t=16.506,14.557,P<0.05).The total incidence of postpartum hemorrhage and birth canal injury in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Program-controlled epidural pulse injection for labor analgesia in primipara can effectively increase the vaginal delivery rate,shorten the labor process,reduce complications,and improve the safety of labor analgesia.