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目的探讨单管法与双管法硬膜外分娩镇痛对胎儿头位异常初产妇分娩结局的影响。方法根据产妇病例号的先后顺序将该院收治的440例行经阴道试产的胎儿头位异常初产妇分为单管法硬膜外分娩镇痛组(A组)和双管法硬膜外分娩镇痛组(B组),每组各220例,比较两组产妇分娩结局。结果 B组中第一产程时间、第二产程时间均明显短于A组,差异有统计学意义(t值分别为8.314、6.003,均P<0.05);两组产妇宫口开大程度、第三产程时间之间比较差异无统计学意义(t值分别为0.392、0.112,均P>0.05)。B组胎位转复分娩率、剖宫产率、器械助产率、缩宫素使用率均明显低于A组,第二产程镇痛满意度明显高于A组,差异均有统计学意义(χ~2值分别为6.921、5.558、10.394、15.337、13.007,均P<0.05)。B组持续性枕后位、枕横位和产程停滞率明显低于A组,差异均有统计学意义(χ~2值分别为4.391、6.667,均P<0.05)。两组新生儿体重、娩出1 min Apgar评分、5 min Apgar评分比较差异无统计学意义(t值分别为0.592、0.290、0.331,均P>0.05)。结论双管法硬膜外分娩镇痛用于胎头位置异常初产妇的分娩结局优于单管法,值得在产科分娩中推广应用。
Objective To investigate the effect of single-tube and double-tube epidural analgesia on the delivery outcome of fetal head abnormalities in primipara. Methods Based on the order of maternal cases, 440 cases of vaginal preterm labor born in the hospital were randomly divided into single-tube epidural analgesia group (group A) and double-tube epidural Labor analgesia group (B group), each group of 220 cases, compared two groups of maternal childbirth outcomes. Results The time of the first stage of labor and the second stage of labor were significantly shorter in group B than in group A (t = 8.314 and 6.003, respectively, all P <0.05) There was no significant difference between the three birth courses (t = 0.392,0.112, all P> 0.05). The rate of cesarean section delivery, cesarean section rate, device birth rate and oxytocin utilization rate in group B were significantly lower than those in group A, and the satisfaction rate in the second stage of labor was significantly higher than that in group A χ ~ 2 values were 6.921,5.558,10.394,15.337,13.007, all P <0.05). The persistent posterior occiput posterior position, occipital transverse position, and labor delay in group B were significantly lower than those in group A (χ ~ 2 = 4.391,6.667, P <0.05, respectively). There was no significant difference in body weight, Apgar score at 1 min and Apgar score at 5 min between the two groups (t = 0.592, 0.290 and 0.331, respectively, P> 0.05). Conclusions The dual-tube epidural analgesia is superior to single-tube method in the delivery of abnormal primiparous mothers, which is worthy of promotion and application in obstetric labor.