摘要
目的:探讨新产程标准下初产妇分娩镇痛不同实施时机对产程、分娩方式及母婴结局的影响。方法:选取2022年1月—2023年2月于滕州市中心人民医院行自然分娩的129例初产妇,按照不同分娩镇痛时机分成Ⅰ组(n=43,宫口扩张≤2 cm)、Ⅱ组(n=43,2 cm<宫口扩张<3 cm)与Ⅲ组(n=43,宫口扩张≥3 cm)。所有初产妇均接受连续硬膜外阻滞分娩镇痛。对三组产程、镇痛效果、分娩方式及母婴结局进行比较。结果:三组自然分娩率、中转剖宫产率比较,差异均无统计学意义(P>0.05);与Ⅰ组、Ⅱ组比较,Ⅲ组第一产程、总产程均更短,第二产程更长(P<0.05);与Ⅰ组比较,Ⅱ组第一产程、总产程均更短,第二产程更长(P<0.05);Ⅲ组镇痛总有效率(95.35%)较Ⅰ组(73.81%)、Ⅱ组(78.57%)更高,差异均有统计学意义(P<0.05);Ⅲ组不良母婴结局发生率(11.63%)较Ⅰ组(34.88%)、Ⅱ组(30.23%)更低,差异均有统计学意义(P<0.05)。结论:宫口扩张≥3 cm时实施分娩镇痛虽然会延长第二产程,但能够缩短第一产程及总产程,提高镇痛效果,降低不良母婴结局发生率,临床可根据初产妇实际情况,合理选择分娩镇痛时机。
Objective:To explore the effect of labor analgesia at different timing on labor,delivery mode and maternal and infant outcomes of primipara under the new labor standard.Method:A total of 129 primiparas who had natural delivery in Tengzhou Central People's Hospital from January 2022 to February 2023 were selected and divided into group Ⅰ(n=43,dilatation of cervix≤2 cm),group Ⅱ(n=43,2 cm<dilatation of cervix<3 cm)and group Ⅲ(n=43,dilatation of cervix≥3 cm)according to different delivery analgesia timing.All primiparas received continuous epidural block for labor analgesia.The labor,analgesic effect,delivery mode and maternal and infant outcomes of the three groups were compared.Result:There were no significant differences in natural delivery rate and transit cesarean section rate among the three groups(P>0.05).Compared with group Ⅰ and group Ⅱ,the first and total stage of labor in group Ⅲ were shorter,and the second stage of labor was longer(P<0.05).Compared with group Ⅰ,the first and total stage of labor in group Ⅱ were shorter,and the second stage of labor was longer(P<0.05).The total effective rate of analgesia in group Ⅲ(95.35%)was higher than that in groupⅠ(73.81%)and group Ⅱ(78.57%),the differences were statistically significant(P<0.05).The incidence of adverse maternal and infant outcomes in group Ⅲ(11.63%)was lower than that in group Ⅰ(34.88%)and group Ⅱ(30.23%),the differences were statistically significant(P<0.05).Conclusion:Although labor analgesia when dilatation of cervix≥3 cm will prolong the second stage of labor,it can shorten the first and total stage of labor,improve the analgesia effect,and reduce the incidence of adverse maternal and infant outcomes,the timing of labor analgesia can be reasonably selected according to the actual situation of primipara in clinic.
作者
吕晓辉
LYU Xiaohui(Department of ObstetricsⅠ,Tengzhou Central People's Hospital,Tengzhou 277500,China)
出处
《中国医学创新》
CAS
2024年第11期1-5,共5页
Medical Innovation of China
关键词
新产程标准
初产妇
分娩镇痛
产程
分娩方式
母婴结局
New labor standard
Primipara
Labor analgesia
Labor
Delivery mode Maternal and infant outcomes
作者简介
通信作者:吕晓辉。
