硬膜外分娩镇痛介入时机对高海拔地区初产妇产程曲线的影响

目的分析硬膜外分娩镇痛在高海拔地区初产妇应用中的介入时机及对产程曲线的影响。方法选取2019年12月—2021年1月青海大学附属医院收治的120例行硬膜外分娩镇痛的初产妇作为研究对象。将所有患者依照随机信封法分为A、B、C、D组。A组:全程镇痛,临产后硬膜外分娩镇痛,宫口开全后继续镇痛;B组:硬膜外分娩镇痛,宫口开全后停止镇痛;C组:宫口开至3～5 cm时行硬膜外分娩镇痛,宫口开全后继续镇痛;D组:宫口开至3～5 cm时行硬膜外分娩镇痛,宫口开全后停止镇痛。记录各组初产妇第一产程时间、第二产程时间、产后2 h出血量、新生儿1 min和5 min Apgar评分,采用视觉模拟评分(VAS)评估产妇分娩痛感,绘制产程曲线。结果 A、B组初产妇第一产程时间短于C、D组(P <0.05),A组时间最短(P <0.05)。4组初产妇第二产程时间比较,差异无统计学意义(P>0.05)。4组产后2 h出血量、1 min Apgar评分、5 min Apgar评分比较,差异无统计学意义(P>0.05)。4组产妇中A组VAS评分最低(P <0.05),A组产程曲线最优。结论...

The effects of the timing of epidural analgesia for labor on the labor curve in primiparas from high-land areas

Objective To analyze the timing of epidural analgesia for labor and its effect on labor curve in primiparas from high-land areas.Methods A total of 120 primiparas undergoing epidural analgesia for labor in our hospital from December 2019 to January 2021 were selected. All patients were randomly divided into group A (initiating epidural analgesia right after the onset of parturition with continuous analgesia following the full dilation of the cervix), Group B (initiating epidural analgesia right after the onset of parturition without continuous analgesia following the full dilation of the cervix), Group C (initiating epidural analgesia when the cervix was dilated to 3 to 5 cm with continuous analgesia following the full dilation of the cervix), and group D (initiating epidural analgesia when the cervix was dilated to 3 to 5 cm without continuous analgesia following the full dilation of the cervix). The duration of the first stage of labor, the duration of the second stage of labor, the amount of bleeding within 2 hours after delivery, and the Apgar scores of the newborns at 1 and 5 min were recorded. The pain during labor was evaluated via Visual Analogue Scale (VAS), and the labor curve was plotted.Results The duration of the first stage of labor was shorter in group A and B than that in group C and D, and was the shortest in the group A (P < 0.05). However, there was no significant difference in the duration of the second stage of labor, the amount of bleeding within 2 hours after delivery, or the Apgar scores of the newborns at 1 and 5 min among the four groups (P > 0.05). The group A exhibited the lowest VAS score, as well as the optimal labor curve (P < 0.05).Conclusions Whole-course epidural analgesia for labor can effectively shorten the first stage of labor and improve the labor curve in primiparas from high-land areas.