摘要
目的:分析初产妇行硬膜外分娩镇痛效果及有关影响因素。方法:以便利抽样法选择2021年2月-2022年4月本院接收的初产妇192例,均采取硬膜外分娩镇痛,根据镇痛效果分为良好组和不良组。调查产妇临床资料,分析镇痛效果不良影响因素,根据独立危险因素创建预测模型,应用受试者工作特征(ROC)曲线分析预测模型对镇痛效果不良的预测效力,并以交叉验证法检验预测模型的预测价值。结果:192例中镇痛效果良好171例,占89.1%,镇痛效果不良21例,占10.9%。单因素分析,两组体质指数(BMI)、文化水平、妊娠期糖尿病、产前抑郁、产前焦虑、镇痛时机、胎儿出生体重等有差异(P<0.05);多因素分析,产妇文化水平、妊娠期糖尿病、产前抑郁、产前焦虑、镇痛时机、胎儿出生体重均为硬膜外分娩镇痛效果不良的独立危险因素(P<0.05);ROC曲线分析显示,预测模型预测镇痛效果不良的曲线下面积(AUC)为0.939;应用交叉验证法检验显示,预测模型分类准确率为92.7%(178/192)。结论:初产妇行硬膜外分娩镇痛仍存在一定镇痛不良几率,产妇的文化水平、妊娠期糖尿病、产前抑郁、产前焦虑、镇痛时机、胎儿出生体重均为镇痛不良的危险因素,可据此制定针对性干预措施,以改善镇痛效果。
Objective:To investigate the effect of epidural analgesia in labor of primipara,and to study its related influencing factors.Methods:A total of 192 primiparas had wanted epidural analgesia in labor were selected by convenience sampling from February 2021 to April 2022.These primiparas were divided in group A(women with good analgesia in labor)and group B(women with poor analgesia in labor)based on the labor pain relief.The maternal clinical data in the two groups were investigated,and the influencing factors of analgesia poor efficacy of the primiparas were analyzed.A predictive model of efficacy of the analgesia of the primiparas was established based on the independent risk factors,the predictive efficacy of which was analyzed by receiver operating characteristic(ROC)curve,and the predictive valued of which was tested by cross-validation.Results:Among the 192 primiparas,171(89.1%)primiparas were in group A and 21(10.9%)primiparas were in group B.Univariate analysis showed that there were significant different in body mass index(BMI),education level,gestational diabetes mellitus,prenatal depression,prenatal anxiety,analgesic timing,and fetal birth weight of the primiparas between the two groups(P<0.05).Multivariate analysis showed that maternal education level,gestational diabetes mellitus,prenatal depression,prenatal anxiety,analgesic timing,and fetal birth weight of the primiparas were their independent risk factors of poor epidural analgesic effect(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the predictive model was 0.939.Cross validation showed that the classification accuracy of the predictive model was 92.7%(178/192).Conclusion:There is still a certain probability of poor epidural analgesia in labor of the primipara.Education level,gestational diabetes mellitus,antenatal depression,antenatal anxiety,analgesia timing,and fetal birth weight of the primiparas all are the risk factors of their poor analgesia,so based on this,targeted interventions can be formulated to improve the ana
作者
杨帆
王霓虹
林桑朵
YANG Fan;WANG Nihong;LIN Sangduo(Taizhou Women's and Children's Hospital,Zhejiang Province,318000;Taizhou Hospital of Zhejiang;Taizhou Central Hospital of Zhejiang)
出处
《中国计划生育学杂志》
2023年第1期205-209,共5页
Chinese Journal of Family Planning
关键词
初产妇
硬膜外分娩镇痛
镇痛效果
危险因素
预测模型
Primipara
Epidural analgesia in labor
Analgesic effect
Risk factors
Predictive model
