摘要
目的探讨连续硬膜外分娩镇痛在瘢痕子宫阴道试产产妇中应用的安全性和有效性。方法选择2021年6—12月在本院分娩的瘢痕子宫再次妊娠行阴道试产的产妇200例作为研究对象,按连续硬膜外分娩镇痛和拒绝药物分娩镇痛分为实验组和对照组两组,每组各100例。实验组产妇行连续硬膜外分娩镇痛,对照组产妇拒绝药物分娩镇痛。记录比较两组产妇顺利完成实验人数、分娩结局、分娩过程中视觉模拟(VAS)评分、各产程时间、运动神经阻滞(Bromage)评分、出血量、缩宫素使用率、产妇不良反应、新生儿体重、Apgar评分、脐动脉血气pH值和Lac值等。结果对照组中有23例产妇因无法忍受疼痛而接受硬膜外分娩镇痛,退出实验,对照组产妇77例完成研究;实验组产妇100例全部完成研究。两组产妇阴道分娩率、剖宫产率、产钳助产率、阴道侧切率比较,差异均无统计学意义(P>0.05);在各产程接受连续硬膜外分娩镇痛后,实验组产妇的VAS评分均明显低于对照组,差异有统计学意义(P<0.05);两组产妇分娩过程中各产程时间、Bromage评分、出血量和缩宫素使用率比较,差异均无统计学意义(P>0.05);两组成功生理产产妇新生儿体重、1 min和10 min Apgar评分、新生儿脐动脉血气pH值和Lac值比较,差异均无统计学意义(P>0.05);两组产妇不良反应发生率比较,差异无统计学意义(P>0.05)。结论连续硬膜外分娩镇痛可明显减轻瘢痕子宫阴道试产产妇的分娩过程中的VAS评分,对产妇及新生儿无不良影响,是一种安全且有效的镇痛方式,值得在临床中推广。
Objective To investigate the clinical efficacy and safety of application of continuous epidural labor analgesia in attempt tovaginallabor in parturient with scar uterus.Methods 200 multiparas with scar pregnancy those were trying to give birth vaginally in ourhospital from June 2021 to December 2021 were selected as study objects in this study.These parturient were divided into the following two groups according to their wishes:experimental group(administered with continuous epidural labor analgesia during delivery,n=100),and control group(refused to use any analgesic drug during delivery,n=100).The number of parturient women who successfully completed the experiment,delivery outcome,visual analogue scale(VAS)score during delivery,duration of labor,motor nerve block(Bromage)score,blood loss,utilization rate of oxytocin,maternal adverse reactions,newborn weight,Apgar score,pH value and Lac value of umbilical artery blood gas were recorded and compared between the two groups.Results Among them,23 multiparas in the control group withdrew from the trial and then received continuous epidural labor analgesia due to unbearable pain,and 77 parturient women finished the study.All 100 parturients in the experimental group completed the study.There were no significant differences invaginal delivery rate,cesarean section rate,obstetric forcepsassisted delivery rate,and perineal lateral resection rate between the two groups(P>0.05).After continuous epidural labor analgesia at each stage of labor,VAS score of the experimental group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).There were no significant differences in labor time,Bromage score,blood loss and utilization rate of oxytocin between the two groups(P>0.05).There were no significant differences in neonatal weight,Apgar score at 1min and 10min,pH and Lac of umbilical artery blood gas between the two groups(P>0.05).There was no significant difference in the incidence of maternal adverse reactions between the two groups(P>0.05).Conclusions Continuous epidural labor analgesia could significantly relieve the VAS score of parturient with scar uterus in vaginal trial labor,and has no adverse effects on the puerpera and newborn,It is a safe and effective way to relieve pain,and is worthy of clinical promotion.
作者
雷黎明
钱青青
蒋佳男
钱夏丽
王朝辉
冯善武
Lei Liming;Qian Qingqing;Jiang Jianan;Qian Xiali;Wang Zhaohui;Feng Shanwu(Department of anesthesiology,affiliated obstetrics and gynecology hospital of Nanjing Medical University,Nanjing,Jiangsu,210004,China.)
出处
《齐齐哈尔医学院学报》
2022年第11期1030-1034,共5页
Journal of Qiqihar Medical University
关键词
分娩镇痛
阴道试产
瘢痕子宫
母婴结局
Continuous epidural analgesia
Vaginal trial labor
Scar uterus
Maternal and infant outcome
作者简介
通信作者:冯善武,Email:shanwufeng@163.com。
