腰麻-硬膜外联合阻滞镇痛对分娩情况的影响

Effect of Combined Spinal Anesthesia-Epidural Block Analgesia on Labor

目的:探讨腰麻-硬膜外联合阻滞镇痛对分娩结局的影响。方法:回顾性分析2022年1—10月甘肃省玉门市第一人民医院收治的104例产妇的临床资料,根据临产后是否接受腰麻-硬膜外联合阻滞镇痛分为研究组(接受腰麻-硬膜外联合阻滞镇痛)和对照组(不接受腰麻-硬膜外联合阻滞镇痛),各52例。比较两组分娩方式、剖宫产分娩指征、产程时间、产时发热及并发症发生情况。结果:两组阴道分娩、剖宫产率比较,差异无统计学意义(P>0.05);研究组器械助产率高于对照组,差异有统计学意义(P=0.046)。两组宫内感染、潜伏期/活跃期延长、持续性枕横位/枕后位、胎儿窘迫发生率比较,差异无统计学意义(P>0.05);研究组活跃期停滞、相对头盆不称发生率高于对照组,差异有统计学意义(P<0.05)。研究组第一产程、活跃期及第二产程时间长于对照组,差异有统计学意义(P<0.001);两组潜伏期及第三产程时间比较,差异无统计学意义(P>0.05)。研究组产时发热发生率高于对照组,差异有统计学意义(P=0.027);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:腰麻-硬膜外联合阻滞镇痛会提升产妇器械助产率,延长产程,提高产妇产时发热率。

Objective:To investigate the effect of combined spinal anesthesia-epidural block analgesia on labor outcomes.Methods:The clinical data of 104 parturients admitted to No.1 Hospital of Yumen City of Gansu Province from January 2022 to October 2022 were retrospectively analyzed.The parturients were divided into a study group(receiving combined spinal anesthesia-epidural block analgesia)and a control group(not receiving combined spinal anesthesia-epidural block analgesia)according to whether they received combined spinal anesthesia-epidural block analgesia before labor,with 52 cases in each group.The mode of delivery,indications for cesarean delivery,labor duration,intrapartum fever,and occurrence of complications were compared between the two groups.Results:There was no significant difference in the rates of vaginal delivery and cesarean section between the two groups(P>0.05).The rate of instrumental midwifery in the study group was higher than that in the control group,and the difference was statistically significant(P=0.046).There were no significant differences in the incidence of intrauterine infection,prolonged incubation/active phase,persistent occipitotransverse position/occipitoposterior position,and fetal distress between the two groups(P>0.05).The incidence of protracted active phase and relative cephalopelvic disproportion in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The duration of the first stage of labor,active phase and second stage of labour in the study group were longer than those in the control group,and the differences were statistically significant(P<0.001).There was no significant difference in incubation period and third stage of labour between the two groups(P>0.05).The incidence of intrapartum fever in the study group was higher than that in the control group,and the difference was statistically significant(P=0.027).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:Combined lumbar anesthesia-epidural block analgesia can improve the rate of instrumental delivery,prolong labor duration,and increase the rate of intrapartum fever.