无痛分娩中实施持续硬膜外麻醉对产程的影响探究

来源:用户上传      作者:聂爱连 万永珍 况敏良

　　[摘要] 目的 探讨持续硬膜外麻醉在临床无痛分娩中的应用及其对产程的影响。 方法 选取2016年1月至2017年10月我院妇产科接收的90例产妇作为研究对象，随机分为对照组和观察组，每组各45例，观察组采用持续硬膜外麻醉后进行分娩，对照组采用传统的自然分娩方法，比较两组活跃期、产程时间、分娩方式，并对孕妇和新生儿的并发症情况、两组镇痛效果进行统计分析。 结果 观察组第一产程及第二产程时间显著短于对照组，差异有统计学意义（P<0.05）;两组产妇在分娩过程中由于活跃期延长行剖宫产术的患者中，与对照组比较观察组显著减少，差异有统计学意义（P<0.05）;两组产妇在分娩过程中由于第二产程时间延长需阴道助产的患者中，与对照组比较观察组显著减少，差异有统计学意义（P<0.05）;与对照组比较，观察组产妇和新生儿并发症的发生率更低，差异有统计学意义（P<0.05）;与φ兆楸冉希观察组1级、2级、3级疼痛显著减少，而0级疼痛显著增加，差异均有统计学意义（P<0.05）。 结论 在无痛分娩中持续硬膜外麻醉，可以提高镇痛效果，达到产程短、剖宫产率低的优点，较大程度提高阴道分娩率，减少产妇及新生儿并发症发生率，确保母婴安全，值得临床产科推广与应用。
　　[关键词] 硬膜外麻醉;无痛分娩;剖宫产;并发症
　　[中图分类号] R714.3 [文献标识码] B [文章编号] 1673-9701（2021）35-0074-03
　　Effect of continuous epidural anesthesia on labor process in painless delivery
　　NIE Ailian1 WAN Yongzhen1 KUANG Minliang2
　　1.Department of Obstetrics and Gynecology， Yichun Maternity and Child Health Care Hospital in Jiangxi Province， Yichun 336000， China; 2.Department of Anesthesiology， Yichun Maternity and Child Health Care Hospital in Jiangxi Province， Yichun 336000， China
　　[Abstract] Objective To investigate the clinical application of continuous epidural anesthesia in painless delivery and its effect on the labor process. Methods A total of 90 parturients in the Department of Obstetrics and Gynecology of our hospital from January 2016 to October 2017 were selected as the study subjects and randomly divided into the control group and the observation group，there were 45 cases in each group. The observation group used continuous epidural anesthesia for delivery， while the control group used the traditional spontaneous delivery method. The active phase， duration of labor， and mode of delivery were compared between the two groups. The complications of pregnant women and newborns and the analgesic effect of the two groups were statistically analyzed. Results The duration of the first stage of labor and the second stage of labor in the observation group were significantly higher than those in the control group， and the difference was statistically significant （P<0.05）. The patients who underwent cesarean section due to prolonged active phase during delivery in the control group were significantly more than those in the observation group， and the difference was statistically significant （P<0.05）. The women who needed vaginal delivery due to the prolonged second stage of labor during delivery in the control group were significantly more than those of the observation group， and the difference was statistically significant （P<0.05）. The incidence rate of maternal and neonatal complications in the observation group was significantly lower than that in the control group， and the difference had statistical significance （P<0.05）. Compared with the control group， the grade 1， 2， and 3 pain in the observation group was significantly reduced， while the grade 0 pain was significantly increased， and the differences had statistical significance （P<0.05）. Conclusion Continuous epidural anesthesia in painless delivery can improve the analgesic effect， achieve a short stage of labor and low cesarean section rate， improve the vaginal delivery rate to a greater extent， reduce the incidence of maternal and neonatal complications， and ensure the safety of mothers and infants. It is worthy of clinical obstetrical promotion and application.
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