硬膜外镇痛对产钳助产分娩结局的影响

doi:10.3969/j.issn.1006-7795.2021.02.026

摘要/Abstract

摘要： 目的分析妊娠足月单胎初产妇产钳助产分娩的临床特征,探讨硬膜外镇痛对产钳助产分娩结局的影响。方法选取2016年1月1日至2016年12月31日首都医科大学附属北京妇产医院产房实施产钳助产分娩的706例产妇为研究对象,根据是否实施硬膜外镇痛分为镇痛组(324例)和对照组(382例),对比观察两组分娩结局。结果 ①足月单胎初产妇中,产钳助产率为7.2%(706/9818),其中产后出血发生率33.6%(237/706),会阴Ⅲ~Ⅳ度裂伤发生率0.99%(7/706),新生儿窒息率4.4%(31/706)。②镇痛组中,产后出血发生率明显高于对照组,差异有统计学意义(P=0.002),但两组的产后出血≥1000 mL的比例,差异无统计学意义(P=0.742)。③镇痛组中,胎儿窘迫的发生率明显低于对照组,差异有统计学意义(P=0.000),但新生儿窒息率比较差异无统计学意义(P=0.513)。结论妊娠足月单胎初产妇中,硬膜外镇痛的孕妇实施产钳助产分娩更容易发生产后出血,但不会增加严重产后出血≥1000mL和新生儿窒息的发生。

关键词: 足月初产妇, 产钳助产, 硬膜外镇痛, 分娩结局

Abstract: Objective To analyze the clinical characteristics of forceps delivery in full-term singleton primiparas and explore the influence of epidural analgesia on the outcomes of forceps delivery.Methods A total of 706 cases of forceps delivery in the delivery room of Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 1,2016 to December 31,2016 were included in this study.Totally 706 cases were divided into epidural analgesia group(324 cases)and control group(382 cases)according to whether epidural analgesia was performed or not and the outcomes of two groups were compared and observed. Results ① Forceps delivery rate was 7.2% (706/9 818),postpartum hemorrhage rate was 33.6% (237/706) ),the incidence of third-fourth degree laceration was 0.99% (7/706), and neonatal asphyxia rate was 4.4% (31/706) in full-term singletons primiparas. ②Postpartum hemorrhage rate in the epidural analgesia group was significantly higher than that in the control group (P=0.002), but there was no significant difference in postpartum hemorrhage (≥1000 mL) between the two groups (P=0.742). ③The fetal distress rate in the epidural analgesia group was significantly lower than that in the control group (P=0.000), but there was no significant difference in neonatal asphyxia rate between the two groups (P=0.513). Conclusion In full-term singletons pimiparas, the epidural analgesia was more likely to be associated with high risk of postpartum hemorrhage in forceps deliveries, but did not increase severe postpartum hemorrhage (≥1000 mL) and neonatal asphyxia.

Key words: full-term singletons primiparas, forceps delivery, epidural analgesia, delivery outcomes

中图分类号:

R714

姜海利, 周建新, 邢宇, 路畅. 硬膜外镇痛对产钳助产分娩结局的影响[J]. 首都医科大学学报, 2021, 42(2): 317-322.

Jiang Haili, Zhou Jianxin, Xing Yu, Lu Chang. Effects of epidural analgesia on the outcomes of forceps delivery[J]. Journal of Capital Medical University, 2021, 42(2): 317-322.

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