硬膜外麻醉分娩镇痛在初产妇中的应用效果及对缩宫素用量、产后出血量的影响

Application effect of epidural anesthesia for labor analgesia in primipara and its influences on oxytocin dosage and postpartum hemorrhage

目的探讨硬膜外麻醉分娩镇痛在初产妇中的应用效果及对缩宫素用量、产后出血量的影响。方法选取2018年1月至2020年1月在本院分娩的160例初产妇作为研究对象,根据随机数字表法将其分为对照组(80例,常规分娩)和观察组(80例,连续硬膜外麻醉分娩镇痛)。比较两组的干预效果。结果观察组的第一、二、三产程及总产程时间短于对照组,缩宫素总用量少于对照组(P<0.05)。观察组的产后2、24 h出血量、产褥感染率、剖宫产率低于对照组,自然分娩率、新生儿娩出时Apgar评分高于对照组(P<0.05)。第一、二、三产程,观察组的视觉模拟评分法(VAS)评分低于对照组(P<0.05);分娩24 h后,观察组的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分低于对照组(P<0.05)。结论硬膜外麻醉分娩镇痛有利于降低初产妇分娩过程中的疼痛感,确保其生命体征始终处于平稳状态,同时还能在一定程度上减少产后出血量,改善其分娩结局及不良心理。

Objective To investigate the application effect of epidural anesthesia for labor analgesia in primipara and its influences on oxytocin dosage and postpartum hemorrhage.Methods A total of 160 primiparas who gave birth in our hospital from January 2018 to January 2020 were selected as the study objects.According to the random number table method,the primiparas were divided into control group(80 cases,routine delivery)and observation group(80 cases,continuous epidural anesthesia for labor analgesia).The intervention effects of the two groups were compared.Results The first,second,third stages of labor and total labor time of the observation group were shorter than those of the control group,and the total amount of oxytocin was less than that of the control group(P<0.05).The 2 h and 24 h postpartum hemorrhage,puerperal infection rate and cesarean section rate in the observation group were lower than those in the control group,and the natural delivery rate and neonatal Apgar score at delivery were higher than those in the control group(P<0.05).In the first,second and third stages of labor,the Visual Analogue Scale(VAS)score of the observation group was lower than that of the control group(P<0.05);after 24 h of delivery,the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores of the observation group were lower than those of the control group(P<0.05).Conclusion Epidural anesthesia for labor analgesia is conducive to reducing the pain of primiparas during delivery,and ensuring that their vital signs are always in a stable state.At the same time,it can also reduce the amount of postpartum hemorrhage to a certain extent,and improve the delivery outcome and bad psychology.