联合麻醉分娩镇痛对正常产妇分娩方式及产程的影响

目的探讨联合麻醉分娩镇痛对正常产妇分娩方式和产程的影响及能否降低正常产妇剖宫产的危险。方法通过对1265例正常产妇资料进行回顾性分析,比较镇痛组和非镇痛组产妇的分娩方式、剖宫产和产钳助产的指征、产程时间及对母儿的影响。结果镇痛组和非镇痛组产妇分娩方式的构成间差别有显著性意义（P〈0.01）;两组产妇剖宫产和产钳助产的指征间差别无显著性意义（P〉0.05）。无论是自然临产还是引产,镇痛组和非镇痛组产妇的第一产程、第二产程及总产程的时间间差别均有显著性意义（P〈0.05）。镇痛组和非镇痛组产后出血率、产褥期疾病发生率、产后尿潴留发生率及新生儿窒息率间差别均无显著性意义（P〉0.05）。结论联合麻醉分娩镇痛不能降低正常产妇的剖宫产率;产钳助产率不受影响;镇痛可使第一和第二产程时间延长,但不增加产后出血、产后尿潴留和产褥期疾病的发生率,不会增加新生儿窒息率。

Effects of Combined Spinal-Epidural Analgesia on Labor

Objective To investigate whether combined spinal-epidural analgesia prolongs labor and increases the risk of cesarean delivery.Methods The data of 1265 cases of normal partutients were taken for retrospective analysis to compare the delivery mode,the indications of cesarean delivery and instrumental delivery,duration of labor,and effects on mothers and fetus between the analgesia and non-analgesia groups.Results There was a significant difference in delivery mode between the analgesia group and the non-analgesia group (P<0.01).There were significant deference in the durations of the first stage,second stage and the general stage of labor between the two groups for both natural and artificial labors (P<0.05).However there was no significant difference between the two groups in the prevalence of postpartum hemorrhage,puerperaisms,postpartum retention of urine,and neonatal asphyxia (P>0.05).Conclusion The combined spinal-epidural analgesia during labor can not reduce the risk of cesarean delivery; and it does not influence the rate of forceps delivery.The analgesia can make the first stage and the second stage of labor prolonged.There is no dangerous for both mother and neonate.