| 摘要: |
| ［摘要］ 目的 探讨产程中镇痛分娩与无镇痛分娩试产的成功率，并分析比较两组试产失败的原因及改行剖宫产术后的相关指标。方法 回顾性分析在产程中行镇痛分娩300例（腰麻-硬膜外联合阻滞麻醉）及无镇痛分娩300例初产妇的临床资料。比较两组产妇试产分娩的成功率，分析比较失败的原因及改行剖宫产术后剖宫产术指征、催产素使用率、术中出血量、产后24 h出血量及新生儿阿氏（Apgar）评分情况。结果 镇痛分娩组300例中试产成功274例，成功率为91.3%，无镇痛分娩组300例中试产成功173例，成功率为57.7%。两组试产失败的主要原因均为胎方位异常、活跃期停滞、胎儿窘迫、产程延长和胎头下降停滞等，其中镇痛分娩组试产失败原因中以胎方位异常、活跃期停滞的发生率显著高于无镇痛分娩组(P<0.05或<0.01)，而胎儿窘迫、产程延长和胎头下降停滞的发生率低于无镇痛分娩组（P<0.05），催产素使用率高于无镇痛分娩组(P<0.01)，改剖宫产术中及产后24 h出血量均多于无镇痛分娩组(P<0.05或<0.01)，新生儿Apgar评分显著高于无镇痛分娩组（P<0.01)。结论 镇痛分娩配合体位指导可提高阴道分娩率，降低剖宫产率，降低新生儿窒息的风险，但对试产失败后行剖宫产术者其子宫收缩会有一定的影响，使催产素使用率增加，术中及术后出血量相对较多。 |
| 关键词: 镇痛 分娩 体位： 母儿影响 |
| DOI：10.3969/j.issn.1674-3806.2012.04.25 |
| 分类号:R 714.3 |
| 基金项目:广西卫生厅科研课题（编号：Z2010468） |
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| Comparision of success rate of trial labor between analgesia and no analgesia labor in birth process and analysis on failure causes of trial labor |
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LIAO Dong-lin, LIAO Ling, CAI Yu-zhen, et al.
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Department of Obstetrics and Gynecology,Nanning Third People′s Hospital,Guangxi 530003,China
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| Abstract: |
| ［Abstract］ Objective To investigate the success rate of trial labor with analgesia and no analgesia in birth process,analyze and compare the failure reason of trial labor and the related index after diverting to cesarean in two groups.Methods The clinical data of primiparas who received combined spinal epidural analgesia in birth process (analgesia group,n=300) and who did not received analgesia in birth process (no analgesia group,n=300) was retrospectively analyzed.The success rate of trial labor,rate of oxytocin use,intraoperative bleeding volume,postpartum 24 h hemorrhage volume and neonatal Apgar score(Apgar) between two groups were compared. Results Of 300 cases in analgesia group, 274 pregnant women were successful in trial labor(accounted for 91.3%). Another 300 cases in no analgesia group, 173 pregnant women were successful in trial labor(accounted for 57.7%). The main causes of the failure of trial labor in the two group were abnormal fetal position, fetal distress, active phase arrest and so on. The rates of abnormal fetal position, and active phase arrest in analgesia group were significantly higher than that in the no analgesia group(P<0.05 or <0.01 ), the rate of oxytocin use in analgesia group was higher than that in no analgesia group(P<0.01); intraoperative and postpartum 24 h bleeding volume in analgesia group were more than that in the no analgesia group(P<0.05 or <0.01). The Apgar score of newborns in the analgesia group was higher than that in no analgesia group(P<0.01). Conclusion The combined spinal-epidural anesthesia analgesia and body position guidance in birth process can improve vaginal delivery rate, reduce the rate of cesarean section and neonatal asphyxia, but have a certain impact on uterine contractions, and increase the rate of oxytocin use and increase intraoperative and postoperative hemorrhage volume after failue of trial labor. |
| Key words: Analgesia Labor Body position Effect on mother and infant |
