论文部分内容阅读
目的:观察分娩镇痛对非选择性剖宫产妊娠结局的影响。方法:选择住院分娩产妇312例,根据自愿原则分为接受分娩镇痛组(观察组)97例和未接受分娩镇痛组(对照组)215例。观察组在宫口开大3cm时采用腰-硬膜外联合阻滞麻醉进行分娩镇痛,对照组不行分娩镇痛。比较两组产程、胎儿娩出时视觉模拟评分(VAS)、运动神经阻滞评分(MBS),以及剖宫产率、产后出血发生率、新生儿窒息发生率和新生儿1min Apgar评分。结果:(1)两组第一产程潜伏期比较,差异不显著(P>0.05);观察组第一产程活跃期和第二产程,均较对照组非常显著延长(P<0.01);两组第三产程比较,差异不显著(P>0.05)。观察组VAS分值非常显著低于对照组(P<0.01),但MBS分值非常显著高于对照组(P<0.01)。(2)观察组剖宫产率15.5%,显著低于对照组的27.0%(P<0.05);产后出血发生率3.1%,与对照组的3.3%比较差异不显著(P>0.05);新生儿窒息发生率6.2%,与对照组的3.3%比较亦差异不显著(P>0.05)。观察组新生儿1min Apgar分值为(8.4±1.3)分,显著低于对照组的(8.8±1.6)分(P<0.05)。结论:分娩镇痛在有效镇痛的同时可显著降低非选择性剖宫产率,且较安全,但在分娩过程中须加强监护。
Objective: To observe the effect of labor analgesia on pregnancy outcome of non-selective cesarean section. Methods: 312 cases of maternal hospital delivery were selected. According to the principle of voluntariness, 97 cases received labor analgesia (observation group) and 215 cases did not receive labor analgesia (control group). The observation group in the cervix 3cm large when the use of lumbar - epidural anesthesia for analgesia labor, the control group not labor analgesia. Visual pressure scores (VAS), motor nerve block scores (MBS), cesarean section rates, postpartum hemorrhage rates, neonatal asphyxia and Apgar scores at 1 minute were compared between the two groups. Results: (1) There was no significant difference between the two groups in the latency of the first stage of labor (P> 0.05). The active stage and the second stage of labor of the first stage of labor in the observation group were significantly longer than those in the control group (P <0.01) Three labor process, the difference was not significant (P> 0.05). The score of VAS in the observation group was significantly lower than that of the control group (P <0.01), but the MBS score was significantly higher than that of the control group (P <0.01). (2) The rate of cesarean section in observation group was 15.5%, which was significantly lower than that in control group (27.0%, P <0.05). The incidence of postpartum hemorrhage was 3.1%, which was not significantly different from that in control group (P> 0.05) The incidence of asphyxia in children was 6.2%, which was not significantly different from the control group (3.3%) (P> 0.05). The Apgar score of neonates in observation group was (8.4 ± 1.3) min at 1 min, which was significantly lower than that of control group (8.8 ± 1.6) min (P <0.05). Conclusion: Analgesia during labor can reduce the rate of non-selective cesarean section significantly while it is effective for analgesia. However, it is safer to give birth during childbirth.