【摘要】 目的观察县乡两级医院产妇行自控硬膜外分娩镇痛对产程及分娩结局的影响,评价县乡两级医院产妇行自控硬膜外分娩镇痛的安全性与可行性。方法选择足月单胎头位妊娠并经阴道试产的初产妇200例,均无硬膜外镇痛禁忌证,根据分娩镇痛要求,将其纳入镇痛组(P组,100例)及对照组(C组,100例)。记录两组第一、二产程及总产程时间,分娩方式,产后出血及催产素使用率,新生儿娩出后1、5min Apgar评分,分娩镇痛的不良反应等。结果 P组较C组的第二产程和总产程显著延长,催产素使用率P组明显高于C组;两组第一产程中转剖宫产率,器械助产率,羊水胎粪污染率,新生儿娩出后1、5min Apgar评分,分娩镇痛的不良反应均无统计学差异。结论硬膜外分娩镇痛可使第二产程及总产程延长、催产素使用率增加,但不增加急诊剖宫产率和经阴道器械助产率,明显降低了社会因素手术率,对分娩结局无不良影响,用于县乡两级医院产妇是安全可行的。更多还原

【Abstract】 Objective To assess the security and reliability of patient-controlled epidural labor analgesia in hospitals of county and township levels,observing the effect of patient-controlled epidural labor analgesia on the duration of labor stages and delivery outcome. Methods 200 cases of single cephalic pregnant primipara were assigned into epidural analgesia group(n=100)and control group(n=100) according to their request when no contraindications were present.Such as the stageⅠ,stageⅡ,total duration of labor,mode of delivery,volume blood loss,oxytocin dosage and after delivery,neonatal 1,5min score of Apgar,adverse reaction of labor analgesia,all were recorded. Results In epidural analgesia group,the duration of stageⅡlabor and the total duration of labor was significantly longer than those in the control group,and the oxytocin usage rate of P group was significantly higher than C group.No significant difference was found between the two groups in the duration of stageⅠ,emergency cesarean section,instrumental delivery,meconium-stained amniotic fluid,neonatal 1,5min score of Apgar and adverse reaction of labor analgesia. Conclusion Epidural labor analgesia prolongs the labor duration,especially the stageⅡ,but it does not increase the incidences of emergency cesarean section or instrumental delivery and does not cause adverse effect on neonatal outcome.Therefore,patient-controlled epidural labor analgesia is security and reliable to generalize in hospitals of county and township levels.更多还原