翁晓英 杨茵

【摘要】 目的：探讨分娩镇痛对初产妇产程和分娩结局的影响。方法：选取2017年10月-2018年5月在福建省立医院南院自愿行椎管内分娩镇痛的85例初产妇作为观察组，并随机抽取91例同期住院分娩但未行分娩镇痛的初产妇为对照组。比较两组产程、分娩结局及母婴结局。结果：分娩镇痛组潜伏期、活跃期、第一产程、第二产程和总产程的时间均明显长于对照组，差异均有统计学意义（P<0.05）。分娩镇痛组应用缩宫素率明顯高于对照组，差异有统计学意义（P<0.05）。两组中转剖宫产发生率、24 h产后出血量、产后出血率、新生儿窒息发生率、新生儿出生1 min Apgar评分、新生儿入住NICU率，差异均无统计学意义（P>0.05）。结论：初产妇行分娩镇痛虽减慢宫口扩张速度，增加催产素使用率，并延长第一、第二产程及总产程时间，但不影响分娩结局及母婴结局。

【关键词】 分娩镇痛; 初产妇; 产程; 母婴结局

doi：10.14033/j.cnki.cfmr.2019.27.025 文献标识码 B 文章编号 1674-6805（2019）27-00-03

Effect of Labor Analgesia on Labor Process and Delivery Outcome of Primipara/WENG Xiaoying，YANG Yin.//Chinese and Foreign Medical Research，2019，17（27）：-59

【Abstract】 Objective：To explore the effect of labor analgesia on labor process and delivery outcome of primipara.Method：From October 2017 to May 2018，in Fujian Provincial Hospital South Branch，85 primiparous women who voluntarily performed intraspinal labor analgesia，were selected as the observation group，and 91 primipara who were delivered in the same period but did not undergo labor analgesia were randomly selected as the control group.The parturition process，parturition outcome and maternal and infant outcome were compared between the two groups.Result：The latency，active period，the duration of first，second and total labor in the labor analgesia group was significantly longer than those in the control group，the differences were statistically significant（P<0.05）.The application rate of oxytocin in labor analgesia group was significantly higher than that in control group，and the difference was statistically significant（P<0.05）.There was no significant difference in the incidence of cesarean section，24-hour postpartum hemorrhage，postpartum hemorrhage rate，incidence of neonatal asphyxia，Apgar score at 1 minute of neonatal birth and NICU occupancy rate between the two groups（P>0.05）.Conclusion：Although labor analgesia slows down the rate of uterine dilation，increases the utilization rate of oxytocin，and prolongs the first and second stages of labor and the total length of labor，it does not affect the outcome of labor and maternal and infant outcomes.

【Key words】 Labor analgesia; Primipara; Duration of labor; Maternal and infant outcome

First-authors address：Fujian Provincial Clinical Medical College of Fujian Medical University，Fuzhou 350000，China

据2010年Lancet杂志的报道，中国非医疗指征的剖宫产率居世界第一位，高达46.2%，是WHO上限标准（15%）的3倍以上，局部地区甚至达到70%以上，而中国分娩镇痛率不到5%[1]。欧美国家分娩镇痛率可达85%，甚至90%以上，剖宫产率仅为10%～20%。国内相关研究显示，非医学指征剖宫产的首要原因是产妇不能忍受或者害怕自然分娩的疼痛[2-3]。因此不论是为了降低无指征剖宫产率，还是为了减轻孕产妇分娩过程中的痛苦，分娩镇痛已成为产科领域的一个重要研究课题[4]。本研究收集2017年10月-2018年5月在福建省立医院南院分娩的85例自愿施行椎管内分娩镇痛的孕妇及91例同期分娩未施行分娩镇痛的孕妇的临床资料进行回顾性分析，探讨分娩镇痛对初产妇产程和分娩结局的影响。

1 资料与方法

1.1 一般资料

收集2017年10月-2018年5月于福建省立医院南院自愿施行椎管内分娩镇痛的孕妇85例作为观察组，并随机抽取同期于该院分娩的未施行分娩镇痛的孕妇91例作为对照组。……