标题：足月妊娠产妇无痛分娩镇痛时机的选择及母婴结局分析

      作者：陈丽英 1，苏尚华 2    儋州市那大镇卫生院妇产科 1、麻醉科 2，海南 儋州 571700

      卷次： 2022年33卷17期

      【摘要】 目的 研究足月妊娠产妇无痛分娩镇痛时机的选择及母婴结局。方法 选择2018年1月至2021年1月期间在儋州市那大镇卫生院妇产科住院分娩的单胎足月产妇100例作为研究对象，按随机数表法分为研究组和对照组，每组50例。研究组产妇在潜伏期(宫口扩张＜3 cm)时实施腰硬联合镇痛分娩，对照组产妇在活跃期(宫口扩张≥3 cm)时实施腰硬联合镇痛分娩。比较两组产妇的镇痛效果、产妇分娩方式、各个产程的时间、产妇母婴的结局与不良反应情况。结果 研究组产妇的镇痛总有效率为96.00%，明显高于对照组产妇的84.00%，差异有统计学意义(P<0.05)；研究组产妇的顺产率、剖宫产率分别为46.00%、32.00%，与对照组的48.00%、32.00%比较差异均无统计学意义(P>0.05)；研究组产妇的第一产程潜伏期为(319.83±75.62) min，明显短于对照组的(563.94±78.59) min，差异有统计学意义(P<0.05)，但两组产妇的第一产程活跃期、第二产程、第三产程比较差异均无统计学意义(P>0.05)；两组产妇的产后出血量、产后开始泌乳时间、羊水污染率，新生儿1 min Apgar评分、新生儿死亡率比较差异均无统计学意义(P>0.05)；研究组和对照组产妇的分娩不良反应总发生率分别为22.00%、20.00%，差异无统计学意义(P>0.05)。结论 足月妊娠产妇选择潜伏期实施腰硬联合镇痛分娩，能明显改善镇痛效果及母婴结局，且不会增加不良反应。
      【关键词】 产妇；分娩镇痛；镇痛时机；第一产程；镇痛效果；母婴结局
      【中图分类号】 R714.1 【文献标识码】 A 【文章编号】 1003—6350（2022）17— 2251—0

3Timing of analgesia and analysis of maternal and infant outcomes in full-term pregnant women undergoingpainless delivery.
CHEN Li-ying 1, SU Shang-hua 2. Department of Obstetrics and Gynecology 1, Department ofAnesthesiology 2, Danzhou Nada Township Health Center, Danzhou 571700, Hainan, CHINA
【Abstract】 Objective To study the timing of analgesia and maternal and infant outcomes in full-term pregnantwomen undergoing painless delivery. Methods A total of 100 singleton full-term pregnant women who were hospital-ized in Department of Obstetrics and Gynecology, Danzhou Nada Township Health Center from January 2018 to January2021 were selected as the research objects. According to the random number table method, they were divided into astudy group and a control group, with 50 women in each group. The pregnant women in the study group were given com-bined spinal-epidural analgesia during the latent period (uterine dilation<3 cm), and the pregnant women in the controlgroup were given combined spinal-epidural analgesia during the active period (uterine dilation≥3 cm). The analgesic ef-fect, mode of delivery, time of each stage of labor, maternal and infant outcomes, and adverse reactions were comparedbetween the two groups. Results The total effective rate of analgesia in the study group was 96.00%, which was signifi-cantly higher than 84.00% in the control group (P<0.05). The rates of spontaneous labor and cesarean section in the studygroup were 46.00% and 32.00% , respectively, which showed no statistically significant difference with 48.00% and32.00% in the control group (P>0.05). The latency of the first stage of labor in the study group was (319.83±75.62) min,which was significantly shorter than (563.94±78.59) min in the control group (P<0.05). However, there was no signifi-cant difference in the first active stage of labor, the second stage of labor, and the third stage of labor between the twogroups (P>0.05). There was no significant difference between the two groups in the amount of postpartum hemorrhage,the time of postpartum lactation, amniotic fluid pollution rate, neonatal 1-minute Apgar score, and neonatal mortality (P>0.05). The total incidence of adverse labor reactions in the study group and the control group were 22.00% and 20.00%,with statistically significant difference (P>0.05). Conclusion The choice of incubation period for painless delivery offull-term pregnant women can significantly improve the analgesic effect and maternal and infant outcomes, which is wor-thy of popularization and application.
      【Key words】 Maternal; Labor analgesia; Timing of analgesia; First stage of labor; Analgesic effect; Maternal andinfant outcome　　　·短篇论著·doi:10.3969/j.issn.1003-6350.2022.17.020