硬膜外麻醉镇痛对自然分娩产程及结局的影响
Effect of epidural anesthesia and analgesia on the course and outcome of spontaneous labor
张洁 1方微园 2李爱红1
作者信息
- 1. 复旦大学附属闵行医院(上海市闵行区中心医院)妇产科 上海 201199
- 2. 复旦大学附属儿科医院感染传染科 上海 201102
- 折叠
摘要
目的:探讨硬膜外麻醉镇痛对自然分娩产程及结局的影响.方法:回顾性分析 197 例孕妇资料,根据产次和分娩镇痛与否分为初产妇镇痛组(n=79)、初产妇对照组(n=44)、经产妇镇痛组(n=45)和经产妇对照组(n=29),比较组间疼痛视觉模拟(VAS)评分、产程时间、产后 2 h出血量、新生儿Apgar评分、剖宫产率等.结果:初产妇镇痛组VAS评分和剖宫产率低于对照组,但第二产程时间长于对照组(均P＜0.05),其他指标差异无统计学意义.经产妇镇痛组VAS评分低于对照组(P＜0.05),其他指标差异无统计学意义.结论:硬膜外麻醉镇痛均可缓解初、经产妇产痛,延长初产妇第二产程,并可降低初产妇剖宫产率,然而对其他产程、产后出血量、新生儿Apgar评分均无显著影响.
Abstract
Objective:To investigate the effect of epidural anesthesia and analgesia on the process and outcome of spontaneous labor.Methods:The data from 197 pregnant women were retrospectively analyzed,and they were divided into a primigravid analgesia group(n=79),a primigravid control group(n=44)and a transplacental analgesia group(n=45)and a transplacental control group(n=29)according to the number of labor and the presence or absence of analgesia in labor.The visual analogue score(VAS)of pain,duration of labor,hemorrhage in postpartum 2 h,neonatal Apgar score,and the cesarean section rate were compared among the groups.Results:The VAS score and the caesarean section rate was lower and the duration of the second stage of labor was longer in the primigravida analgesia group than the control group(all P<0.05),and the differences in other indicators were not statistically significant.The VAS score of the transplacental analgesia group was lower than that of the control group(P<0.05),and the differences in other indicators were not statistically significant.Conclusion:Epidural anesthesia analgesia can relief labor pain of primiparous and transient women,extend the second stage of labor of primiparous women and reduce the rate of caesarean section in primiparous women,however,it has no significant effect on the other stages of labor,post-partum hemorrhage and neonatal Apgar score.
关键词
硬膜外麻醉/镇痛分娩/产程时间/分娩结局/剖宫产率Key words
epidural anesthesia/analgesic labor/duration of labor/outcome of labor/cesarean section rate引用本文复制引用
基金项目
上海市闵行区卫生健康委项目(2019MW10)
出版年
2024
NETL
NSTL
万方数据