Influence of patient-controlled epidural labor analgesia on labor process and maternal and infant prognosis
自控硬膜外分娩镇痛对产程和母婴预后的影响

摘要

目的 探讨在分娩过程中采用自控硬膜外分娩镇痛对产程和母婴预后的影响。方法 研究起始阶段为2021年5月，结束时间节点为2022年5月，该阶段纳入的研究样本均由我院中妇产科接受分娩的初产妇，样本量为500例。选取完成后整理产妇的相关资料，进行回顾性分析，根据产妇分娩时是否接受罗哌卡因联合芬太尼自控硬膜外镇痛进行分组，即镇痛组（接受自控硬膜外分娩，n=167例）和非镇痛组（未接受自控硬膜外分娩，n=333），对不同类型产妇的产程、疼痛评分、分娩结局，并对比之间存在的区别。结果 比较两组不同产程中产妇的VAS评分，镇痛组均低于非镇痛组，存在明显差异和统计学意义（P＜0.05）。比较两组潜伏期和活跃期时间，非镇痛组均长于镇痛组；镇痛组第二产程时间高于非镇痛组，存在显著差异和统计学意义（P＜0.05）。与非镇痛组相比，镇痛组阴道分娩率较高（P＜0.05）；比较两组胎儿窘迫发生率及Apgar评分，无明显差异不具有统计学意义（P＞0.05）。结论 采用自控硬膜外分娩镇痛，有利于促进顺产率提高，且应用后母婴并发症不会增加，具有较高的安全性和有效性，在分娩镇痛中可加大借鉴力度。

Abstract

Objective To investigate the effect of patient-controlled epidural labor analgesia on labor and maternal and infant prognosis during labor.
Methods The start stage of the study was May 2021, and the end time node was May 2022. The study samples included in this stage were all primiparas who received delivery in the obstetrics and gynecology department of our hospital, with a sample size of 500 cases. After selecting and sorting out the relevant data of the puerperae, a retrospective analysis was carried out. According to whether the puerpera received ropivacaine combined with fentanyl patient-controlled epidural analgesia during delivery, they were divided into groups, namely the analgesia group (receiving patient-controlled epidural delivery, n=167 cases) and the non-analgesic group (not receiving patient-controlled epidural delivery, n=333), the differences in labor process, pain scores, and delivery outcomes for different types of mothers were compared.
Results Comparing the VAS scores of puerperae in different stages of labor between the two groups, the analgesic group was lower than the non-analgesic group, with significant differences and statistical significance (P<0.05). Comparing the latent period and active period of the two groups, the non-analgesic group was longer than the analgesic group; the analgesic group was longer than the non-analgesic group in the second stage of labor, with significant differences and statistical significance (P<0.05). Compared with the non-analgesic group, the analgesic group had a higher rate of vaginal delivery (P<0.05). There was no significant difference in the incidence of fetal distress and Apgar score between the two groups (P>0.05).
Conclusion   The use of self-controlled epidural analgesia in labor is beneficial to improve the rate of vaginal delivery, and the maternal and infant complications will not increase after application. It has high safety and effectiveness, and can be used for reference in labor analgesia.