许宽宽 吴朝勇

[摘要] 目的 探讨初产妇潜伏期分娩镇痛对产程及安全分娩的影响。 方法 选取2020年1—12月绍兴市柯桥区妇幼保健院产科收治的480例初产妇，按照随机数字表法将其分为对照组和观察组，每组各240例;对照组在活跃期进行分娩镇痛，而观察组在潜伏期就进行分娩镇痛;比较两组干预后的产程时间、VAS评分、剖宫产率、1 min Apgar评分、新生儿呼吸窘迫综合征发生率及产后泌乳始动时间。 结果 观察组的第一产程时间（339.14±108.52）min、第二产程时间（48.80±7.99）min、VAS评分（7.27±1.05）分，均低于对照组的（405.72±115.39）min、（60.34±12.45）min、（9.04±0.81）分，差异有统计学意义（P<0.01）;观察组的剖宫产率为10.83%，低于对照组的25.00%，差异有统计学意义（P<0.01）;观察组的1 min Apgar评分高于對照组，差异有统计学意义（P<0.01）;而观察组的新生儿呼吸窘迫综合征发生率为3.75%，低于对照组的11.25%，差异有统计学意义（P<0.01）;观察组产后泌乳始动时间明显短于对照组，差异有统计学意义（P<0.01）。 结论 初产妇在潜伏期进行分娩镇痛，可缩短产程时间和产后泌乳始动时间，缓解分娩疼痛，降低剖宫产率、窒息发生率及新生儿呼吸窘迫发生率，提高安全分娩水平。

[关键词] 初产妇;分娩镇痛;潜伏期;安全分娩;妊娠结局

[中图分类号] R714.3          [文献标识码] B          [文章编号] 1673-9701（2021）32-0074-04

[Abstract] Objective To explore the effect of labor analgesia at latent phase on labor process and safe delivery in primiparas. Methods A total of 480 primiparas admitted to the Department of Obstetrics and Gynecology of Shaoxing Keqiao Women & Children′s Hospital from January to December 2020 were selected. They were randomly divided into the control group and the observation group using random number table method，with 240 primiparas in each group. The control group were given labor analgesia at active phase，and the observation group were given labor analgesia at latent phase. The labor time， VAS score， cesarean section rate， 1 min Apgar score， incidence of neonatal respiratory distress and postpartum lactation initiation time were compared between the two groups. Results The time of first stage of labor （339.14±108.52）min， time of second stage of labor （48.80±7.99）min， and VAS score （7.27±1.05） points in the observation group were lower than those of （405.72±115.39）min， （60.34±12.45）min， （9.04 ±0.81）points in the control group，with significant difference（P<0.01）. The cesarean section rate in the observation group was 10.83%， which was lower than that of 25.00% in the control group，with significant difference（P<0.01）. The 1min Apgar score in the observation group was higher than that in the control group，with significant difference（P<0.01）. The incidence of neonatal respiratory distress in the observation group was 3.75%， which was lower than that of 11.25%in the control group ，with significant difference（P<0.01）. The postpartum lactation initiation time in the observation group was significantly shorter than that in the control group，with significant difference（P<0.01）. Conclusion The labor analgesia at latent phase can shorten labor time and postpartum lactation initiation time， relieve labor pain， reduce cesarean section rate， incidence of asphyxia and incidence of neonatal respiratory distress，and improve level of safe delivery in primiparas.

[Key words] Primipara; Labor analgesia; Latent phase; Safe delivery; Pregnancy outcome

分娩疼痛是初产妇疼痛指数极高的医学疼痛，可对初产妇的身心带来巨大的压力，剧烈疼痛会引起宫缩乏力、晕厥、休克、难产等[1]，部分产妇无法忍受分娩疼痛而选择剖宫产，甚至对围产儿也会产生较大影响[2]。以往分娩镇痛中多采取药物镇痛分娩、水中分娩等多种镇痛措施进行分娩镇痛，减轻患者分娩过程中的痛感及对分娩过程的恐惧。……