国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
15期
2150-2152
,共3页
王保平%马云燕%朱晓琳%贾晓江%黄小鹏%尹春艳
王保平%馬雲燕%硃曉琳%賈曉江%黃小鵬%尹春豔
왕보평%마운연%주효림%가효강%황소붕%윤춘염
硬膜外阻滞分娩镇痛%剖宫产率%临产后剖宫产率
硬膜外阻滯分娩鎮痛%剖宮產率%臨產後剖宮產率
경막외조체분면진통%부궁산솔%임산후부궁산솔
Epidural block for labor analgesia%Rate of Cesarean section%Rate of Cesarean section after parturiency
目的 探讨硬膜外阻滞分娩镇痛的规模化实施对临产后剖宫产率及剖宫产指征的影响.方法 总结1999、2009年2年份1-12月所有孕足月分娩、完整在案的病历2885例,分析2年份的硬膜外阻滞分娩镇痛率、总剖宫产率及临产进入活跃期后试产失败剖宫产率及剖宫产指征的变化.结果 (1)分娩镇痛率升高,总剖宫产率下降.1999年硬膜外阻滞分娩镇痛率为17.99％,总剖宫产率为40.80％; 2009年硬膜外阻滞分娩镇痛率为51.23％,总剖宫产率为27.81％,差异有极显著性(P＜0.001).(2)临产进入活跃期后,试产不成功剖宫产率呈逐年下降趋势,1999年为6.78％,2009年为3.78％,差异有显著性(P＜0.05).(3)进入活跃期试产失败病例平均试产时间和宫颈口扩张程度呈逐年增加趋势,1999年,试产失败病例平均试产时间( 164.11±55.35) min,试产失败时平均宫口扩张程度(5.30±2.05) cm; 2009年,试产失败病例平均试产时间(284.50±84.66)min,试产失败时平均宫口扩张程度(7.00±1.83)cm;差异有显著性(P＜0.05).(4)实施规模化分娩镇痛后,头位难产发生率及社会因素剖宫产率均下降.1999年头位难产剖宫产率48.08％,2009年头位难产剖宫产率35.00％,差异有显著性(P＜0.05).1999年临产后不合理剖宫产率23.08％,2009年临产后不合理剖宫产率2.50％,差异有极显著性(P＜0.001).结论 规模化开展硬膜外阻滞分娩镇痛能降低剖宫产率特别是降低社会因素剖宫产率及临产后不合理剖宫产率降低头位难产的发生率.
目的 探討硬膜外阻滯分娩鎮痛的規模化實施對臨產後剖宮產率及剖宮產指徵的影響.方法 總結1999、2009年2年份1-12月所有孕足月分娩、完整在案的病歷2885例,分析2年份的硬膜外阻滯分娩鎮痛率、總剖宮產率及臨產進入活躍期後試產失敗剖宮產率及剖宮產指徵的變化.結果 (1)分娩鎮痛率升高,總剖宮產率下降.1999年硬膜外阻滯分娩鎮痛率為17.99％,總剖宮產率為40.80％; 2009年硬膜外阻滯分娩鎮痛率為51.23％,總剖宮產率為27.81％,差異有極顯著性(P＜0.001).(2)臨產進入活躍期後,試產不成功剖宮產率呈逐年下降趨勢,1999年為6.78％,2009年為3.78％,差異有顯著性(P＜0.05).(3)進入活躍期試產失敗病例平均試產時間和宮頸口擴張程度呈逐年增加趨勢,1999年,試產失敗病例平均試產時間( 164.11±55.35) min,試產失敗時平均宮口擴張程度(5.30±2.05) cm; 2009年,試產失敗病例平均試產時間(284.50±84.66)min,試產失敗時平均宮口擴張程度(7.00±1.83)cm;差異有顯著性(P＜0.05).(4)實施規模化分娩鎮痛後,頭位難產髮生率及社會因素剖宮產率均下降.1999年頭位難產剖宮產率48.08％,2009年頭位難產剖宮產率35.00％,差異有顯著性(P＜0.05).1999年臨產後不閤理剖宮產率23.08％,2009年臨產後不閤理剖宮產率2.50％,差異有極顯著性(P＜0.001).結論 規模化開展硬膜外阻滯分娩鎮痛能降低剖宮產率特彆是降低社會因素剖宮產率及臨產後不閤理剖宮產率降低頭位難產的髮生率.
목적 탐토경막외조체분면진통적규모화실시대임산후부궁산솔급부궁산지정적영향.방법 총결1999、2009년2년빈1-12월소유잉족월분면、완정재안적병력2885례,분석2년빈적경막외조체분면진통솔、총부궁산솔급임산진입활약기후시산실패부궁산솔급부궁산지정적변화.결과 (1)분면진통솔승고,총부궁산솔하강.1999년경막외조체분면진통솔위17.99％,총부궁산솔위40.80％; 2009년경막외조체분면진통솔위51.23％,총부궁산솔위27.81％,차이유겁현저성(P＜0.001).(2)임산진입활약기후,시산불성공부궁산솔정축년하강추세,1999년위6.78％,2009년위3.78％,차이유현저성(P＜0.05).(3)진입활약기시산실패병례평균시산시간화궁경구확장정도정축년증가추세,1999년,시산실패병례평균시산시간( 164.11±55.35) min,시산실패시평균궁구확장정도(5.30±2.05) cm; 2009년,시산실패병례평균시산시간(284.50±84.66)min,시산실패시평균궁구확장정도(7.00±1.83)cm;차이유현저성(P＜0.05).(4)실시규모화분면진통후,두위난산발생솔급사회인소부궁산솔균하강.1999년두위난산부궁산솔48.08％,2009년두위난산부궁산솔35.00％,차이유현저성(P＜0.05).1999년임산후불합리부궁산솔23.08％,2009년임산후불합리부궁산솔2.50％,차이유겁현저성(P＜0.001).결론 규모화개전경막외조체분면진통능강저부궁산솔특별시강저사회인소부궁산솔급임산후불합리부궁산솔강저두위난산적발생솔.
Objective To explore the effect of epidural block for labor analgesia on the rate of Cesarean section after parturiency.Methods We summaried 2,885 pregnant women who gave full-term childbirth in our hospital in the years of 1999 and 2009.We analyzed variation of the rate of epidural block for labor analgesia and Cesarean section.The latter included the variation of the total rate of Cesarean section and of the rate of Cesarean section failing to deliver after parturiency.Results The rate of epidural block for labor analgesia was 17.99％ in 1999 but 51.23％ in 2009.The rate of Cesarean section was 40.80％ in 1999 but 27.81％ in 2009.There were significant differences in the rates of epidural block for labor analgesia and Cesarean section between the two years( P＜ 0.001 ).The rate of Cesarean section failing to deliver after parturiency was 6.78％ in 1999 and 3.78％ in 2009,with a significant difference ( P＜ 0.05 ).The average time to parturiency to Cesarean section and the average degree of cervical dilatation were both increased.The average time to parturiency to Cesarean section was ( 164.11 ± 55.35 ) minutes and the dilation degree was ( 5.3 ± 2.05 ) cm in 1999 while it was ( 284.50 ± 84.66 ) minutes and ( 7.0 ± 1.83 ) cm in 2009,respectively; there was a significant difference between the two years ( P ＜ 0.05 ).The rates of ephalic dystocia and Cesarean section because of social factors were decreased after epidural block for labor analgesia.Conclusions Epidural block for labor analgesia can decrease the rates of Cesarean section and cephalic dystocia.
