摘要
目的:探讨硬膜外双管阻滞在足月妊娠分娩中的应用效果。方法:采用前瞻性研究法,将2021年1月-2022年12月在本院阴道试产的352例足月妊娠产妇随机分为两组(各176例),均行镇痛分娩,分别采用硬膜外双管阻滞麻醉(双管组)或硬膜外单管阻滞麻醉(单管组)。对比两组镇痛效果、剖宫产率、产程、新生儿评分、麻醉并发症等情况。结果:两组宫口开至4cm、宫口至10cm、胎儿娩出后即刻VAS评分均较分娩镇痛前降低,且双管组(4.20±0.48分、4.52±0.54分、4.43±0.62分)均低于单管组(5.81±0.87分、6.72±1.20分、6.80±1.14分)(均P<0.05)。与单管组相比,双管组自然分娩率更高(81.8%比60.2%),剖宫产率更低(17.1%比36.9%),缩宫素使用率更低(56.8%比80.1%),分娩体验满意率(97.7%比52.3%)更高,第一产程(570.87±178.52min)、第二产程(49.64±12.36 min)及总产程时间(625.51±58.44 min)均短于单管组(632.35±165.75 min、62.48±13.29 min、712.49±64.87 min)(均P<0.05)。新生儿出生后1min、5min、10min Apgar评分无差异,麻醉并发症、软产道损伤、新生儿窒息及新生儿产伤发生率两组均无差异(P>0.05)。双管组产后出血(6.8%)、会阴侧切发生率(5.7%)低于单管组(18.2%、19.9%)(P<0.05)。结论:足月妊娠产妇镇痛分娩中采用硬膜外双管阻滞麻醉镇痛效果更佳,可加快产程,促进自然分娩,提高分娩质量。
Objective:To explore the effect of epidural double-tube block for labor analgesia of women with full-term pregnancy.Methods:A prospective study was conducted in 352full-term pregnant women who wanted vaginal trial delivery From January 2021to December 2022.These women were given labor analgesia and were randomly divide into two groups(176cases in each group).The women in the observation group were given epidural double-tube block anesthesia,and the women in the control group were given epidural single-tube block anesthesia.The analgesic effect,the cesarean section rate,the labor process,the neonatal score,and the anesthesia complications of the women were compared between the two groups.Results:After labor analgesia,the VAS score of the women in the two groups at the cervix opened to 4cm,at the cervix opened to 10cm,or immediately after fetal delivery had decreased significantly,and which of the women in the observation group(4.20±0.48points,4.52±0.54points,or 4.43±0.62points)was significantly lower than that(5.81±0.87points,6.72±1.20points,or 6.80±1.14points)of the women in the control group(all P<0.05).The rates of natural delivery and the delivery experience satisfaction(81.8%and 97.7%)of the women in the observation group were significantly higher than those(60.2%and 52.3%)of the women in the control group.The rates of the cesarean section and the use of oxytocin(17.1%and 56.8%)of the women in the observation group were significantly lower than those(36.9%and 80.1%)of the women in the control group.The duration of the first stage of labor(570.87±178.52min),the duration of the second stage of labor(49.64±12.36min),and the duration of the total labore(625.51±58.44min)of the women in the observation group were significantly shorter than those(632.35±165.75min,62.48±13.29min,and 712.49±64.87min)of the women in the control group(all P<0.05).There were no significant differences in the neonatal Apgar scores at 1,5and 10min after birth between the two groups.There were no significant differences in the r
作者
黄微哲
尹燕
徐丽霞
HUANG Weizhe;YIN Yan;XU Lixia(Dongying District People's Hospital of Dongying,Dongying Shandong Province,257000;Dongying Central Hospital,Dongying,Shandong Province)
出处
《中国计划生育学杂志》
2023年第12期2884-2888,共5页
Chinese Journal of Family Planning
关键词
足月妊娠
分娩镇痛
硬膜外阻滞
双管
Full-term pregnancy
Labor analgesia
Epidural block
Double-tube
