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目的探讨不同时机实施硬膜外镇痛分娩(PCEA)的临床效果及对母婴的影响。方法选择临产后自愿要求硬膜外镇痛分娩的200例足月单胎初产妇为研究对象。按随机数字表法分为潜伏期组和活跃期组,潜伏期组100例(宫口扩张<3 cm);活跃期组100例(宫口扩张≥3 cm),均实施硬膜外镇痛分娩。另外选取同期未实行分娩镇痛的100例初产妇为对照组。比较三组疼痛评分(VAS)、镇痛药物用量、产程时间、催产素用量、分娩方式及助产率、产后出血量及新生儿Apgar评分。结果三组VAS镇痛评分比较,潜伏期组<活跃期组<对照组(P<0.05);镇痛药物用量潜伏期组>活跃期组(P<0.05);第一产程和第三产程比较,差异无统计学意义(P>0.05);潜伏期组和活跃期组的第二产程较对照组明显增长(P<0.05)。催产素使用量比较潜伏期组>活跃期组>对照组(P<0.05);剖宫产率及助产率比较,差异无统计学意义(P>0.05);产后出血和新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论实施硬膜外镇痛分娩会增加镇痛药物及催产素的使用量,但对母婴的安全性无影响,而于潜伏期镇痛可以提高产妇的满意度。
Objective To investigate the clinical effects of different epidural analgesia and delivery (PCEA) and their effects on maternal and infant. METHODS: A total of 200 full-term single-born primiparae women who were asked for voluntary epidural analgesia after labor were selected as study subjects. According to the random number table method, the patients in the latent period group and the active period group were divided into two groups: 100 in the latency group (<3 cm in the cervix), 100 in the active group (≥3 cm in the cervix). All patients underwent epidural analgesia. In addition, 100 cases of primiparous women who did not undergo labor analgesia during the same period were selected as the control group. Pain scores (VAS), analgesic drug use, labor duration, oxytocin dosage, mode of delivery and midwifery rate, postpartum hemorrhage volume and neonatal Apgar score were compared. Results Compared with the control group (P <0.05), the latent period of the analgesic drugs> the active period group (P <0.05), the differences of the VAS analgesic scores between the three groups were statistically significant No significant difference was found between the two groups (P> 0.05). The second stage of labor in latent period and active stage was significantly higher than that in control group (P <0.05). (P <0.05); cesarean section rate and midwifery rate, the difference was not statistically significant (P> 0.05); postpartum hemorrhage and neonatal Apgar score, The difference was not statistically significant (P> 0.05). Conclusion Epidural analgesia delivery increases the use of analgesics and oxytocin, but has no effect on maternal and child safety, whereas analgesia during the incubation period improves maternal satisfaction.