硬膜外麻醉在分娩镇痛中的临床效果和对分娩结局的影响

Clinical Effect of Epidural Analgesia in Labor Analgesia and Its Impact on Labor Outcomes

目的探讨硬膜外麻醉在分娩镇痛中的临床效果和对分娩结局的影响。方法方便选取2020年12月—2021年12月于南京市江宁医院建档并计划分娩的产妇120例,根据产妇个人意愿将其分为正常分娩组(未接受分娩镇痛)与镇痛分娩组(接受分娩镇痛,行硬膜外麻醉处理),各60名,比较两组产妇分娩结局、产程时间(包括第一产程、第二产程、第三产程时长)、疼痛程度、动脉和静脉血气分析值[包括血氧分压(PO_(2))、二氧化碳分压(PCO_(2))、pH值和血氧饱和度(SO_(2))]。结果两组分娩结局差异无统计学意义(P>0.05);镇痛分娩组第一产程(421.36±50.37)min较正常分娩组(486.45±62.11)min明显缩短,第二产程(40.37±8.67)min较正常分娩组(35.15±8.54)min有所延长,差异有统计学意义(t=6.305、3.323,P<0.05),镇痛分娩组产程活跃期、产时、胎儿娩出时VAS评分低于正常分娩组,差异有统计学意义(P<0.05),胎儿娩出后,正常分娩组和镇痛分娩组动静脉血气分析指标比较,差异无统计学意义(P>0.05)。结论硬膜外麻醉可有效缓解产妇分娩疼痛症状,可加速第一产程进展(特别是活跃期),提升自然分娩率。

Objective To investigate the clinical effect of epidural anesthesia in labor analgesia and its influence on labor outcomes.Methods A total of 120 pregnant women who had been documented and planned to deliver in the Nanjing Jiangning Hospital from December 2020 to December 2021 were conveniently selected.According to their personal wishes,they were divided into a normal delivery group(without labor analgesia)and an analgesic labor group(with labor analgesia and epidural anesthesia),with 60 cases in each group.The labor outcomes,labor duration(including the duration of the first,second,and third stages of labor),pain levels,and arterial and venous blood gas analysis values[including partial pressure of oxygen(PO_(2))and partial pressure of carbon dioxide(PCO_(2))and pH and oxygen saturation(SO_(2))]were compared between the two groups.Results There was no statistically significant difference in the delivery outcome between the two groups(P>0.05).The first stage of labor(421.36±50.37)min in the analgesic delivery group was significantly shorter than the normal delivery group(486.45±62.11)min,and the second stage of labor(40.37±8.67)min was longer than the normal delivery group(35.15±8.54)min,the difference was statistically significant(t=6.305,3.323,P<0.05).The VAS score of the analgesic delivery group was lower than that of the normal delivery group in the active stage of labor,during labor,and during the delivery of the fetus,the difference was statistically significant(P<0.05).After the fetus was delivered,there was no statistically significant difference in the arterial and venous blood gas analysis indexes between the normal delivery group and the analgesic delivery group(P>0.05).Conclusion Epidural anesthesia can effectively relieve the symptoms of labor pain,accelerate the progress of the first stage of labor(especially the active stage),and improve the natural delivery rate.