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不同时机腰-硬联合分娩镇痛对产妇生理及心理影响的临床研究

樊薇,史玉琴,申希平,张志刚,陈远,洪芳萍   

  1. 甘肃省妇幼保健院,甘肃省妇幼保健院,兰州大学公共卫生学院,兰州大学第一医院,甘肃省妇幼保健院,甘肃省妇幼保健院
  • 收稿日期:2018-11-26 修回日期:2018-11-26 出版日期:2018-11-25
  • 基金资助:
    甘肃省卫生和计划生育委员会项目 (项目编号:GSWSKY2017-6;项目名称:不同时机硬膜外阻滞分娩镇痛对LDR区经阴道分娩产妇生理及心理影响的临床研究)

The Clinical Research on Physiological and Phychological Effects of Combined Spinal Epidural Labor Analgesia at Different Times on Parturients

FAN Wei,SHI Yuqin,SHEN Xiping,ZHANG Zhigang,CHEN Yuan and HONG Fangping   

  1. Maternal and Child Health Care hospital,Maternal and Child Health Care hospital,兰州大学公共卫生学院,兰州大学第一医院,甘肃省妇幼保健院,甘肃省妇幼保健院
  • Received:2018-11-26 Revised:2018-11-26 Online:2018-11-25

摘要: 目的:探讨在产妇宫口扩张的不同时机实施腰-硬联合分娩镇痛对产妇及新生儿的影响。 方法:选取2016年11月至2017年10月在我院国际医疗部LDR病区住院的产妇363例作为研究对象,按照随机抽样法将其分为试验组Ⅰ组(n=84)、Ⅱ组(n=92)、Ⅲ组(n=99);对照组(Ⅳ组,n=88)。试验组(3组)产妇实施分娩镇痛的时机分别是:Ⅰ组产妇子宫口<3 cm、Ⅱ组 3 cm≤子宫口<4 cm、Ⅲ组子宫口≥ 4 cm;对照组为未实施分娩镇痛且无妊娠合并症的足月初产妇。观察4组产妇在不同产程的时长、产后2 h出血、产后焦虑抑郁评分、产后尿潴留、新生儿Apgar评分等方面的差异。结果:第一产程及第二产程时间最短为Ⅱ组;产后2 h出血量最少为Ⅰ组;焦虑评分、抑郁评分最低均为Ⅰ组;新生儿Apgar评分5 min评分分值最高为Ⅱ组;尿潴留最少为Ⅲ组。结论:实施分娩镇痛的时机不同,产生的影响各有利弊,可以通过适当的护理干预,从而选择最佳的镇痛时机。

Abstract: Objective:To explore the effects of combined spinal-epidural labor analgesia at different times during cervical dilatation on parturients and newborns. Methods:363 cases of pregnant women who delivered at LDR ward of international medical department in our hospital during November 2016 to October 2017 were selected as subjects.They were randomly divided into the experimental group Ⅰ(n=84),group Ⅱ(n=92),group Ⅲ (n=99)and the control group (group Ⅳ, n=88). The time of labor analgesia in the experimental group (3 groups) was: group Ⅰ pregnant women cervix<3 cm, group Ⅱ 3 cm ≤cervix<4 cm, group Ⅲ cervix ≥4 cm. The control group was full-term primipara without labor analgesia and had no pregnancy complications.Observe the differences at following aspects which include the time of three stages of labor, postpartum hemorrhage,anxiety score and depression score,postpartum urinary retention,and newborns′ Apgar score. Results: The shortest time of the first and second stages of labor was group Ⅱ, the least bleeding amounts at 2 h was group Ⅰ, the lowest anxiety and depression score was group Ⅰ, the highest score of 5 min′s newborns′Apgar score was group Ⅱ, the least of urinary retention was group Ⅲ. Conclusion:The different time of labor analgesia have both advantages and disadvantages. Optimal analgesia time can be selected by appropriate care intervention.