蛇志
蛇誌
사지
JOURNAL OF SNAKE
2014年
2期
169-170
,共2页
郑贵亮%贺华芳%莫仕安%余平%蒙玉柳%卢洪新%诸葛冬桂%廖海平%李发安%肖展礼%谭宪湖
鄭貴亮%賀華芳%莫仕安%餘平%矇玉柳%盧洪新%諸葛鼕桂%廖海平%李髮安%肖展禮%譚憲湖
정귀량%하화방%막사안%여평%몽옥류%로홍신%제갈동계%료해평%리발안%초전례%담헌호
县乡两级医院%分娩镇痛%产程%分娩结局
縣鄉兩級醫院%分娩鎮痛%產程%分娩結跼
현향량급의원%분면진통%산정%분면결국
Hospitals of county and township levels%Labor analgesia%Labor duration%Delivery outcome
目的：观察县乡两级医院产妇行自控硬膜外分娩镇痛对产程及分娩结局的影响，评价县乡两级医院产妇行自控硬膜外分娩镇痛的安全性与可行性。方法选择足月单胎头位妊娠并经阴道试产的初产妇200例，均无硬膜外镇痛禁忌证，根据分娩镇痛要求，将其纳入镇痛组（P组，100例）及对照组（C组，100例）。记录两组第一、二产程及总产程时间，分娩方式，产后出血及催产素使用率，新生儿娩出后1、5 min Apgar评分，分娩镇痛的不良反应等。结果 P组较C组的第二产程和总产程显著延长，催产素使用率P组明显高于C组；两组第一产程中转剖宫产率，器械助产率，羊水胎粪污染率，新生儿娩出后1、5 min Apgar 评分，分娩镇痛的不良反应均无统计学差异。结论硬膜外分娩镇痛可使第二产程及总产程延长、催产素使用率增加，但不增加急诊剖宫产率和经阴道器械助产率，明显降低了社会因素手术率，对分娩结局无不良影响，用于县乡两级医院产妇是安全可行的。
目的：觀察縣鄉兩級醫院產婦行自控硬膜外分娩鎮痛對產程及分娩結跼的影響，評價縣鄉兩級醫院產婦行自控硬膜外分娩鎮痛的安全性與可行性。方法選擇足月單胎頭位妊娠併經陰道試產的初產婦200例，均無硬膜外鎮痛禁忌證，根據分娩鎮痛要求，將其納入鎮痛組（P組，100例）及對照組（C組，100例）。記錄兩組第一、二產程及總產程時間，分娩方式，產後齣血及催產素使用率，新生兒娩齣後1、5 min Apgar評分，分娩鎮痛的不良反應等。結果 P組較C組的第二產程和總產程顯著延長，催產素使用率P組明顯高于C組；兩組第一產程中轉剖宮產率，器械助產率，羊水胎糞汙染率，新生兒娩齣後1、5 min Apgar 評分，分娩鎮痛的不良反應均無統計學差異。結論硬膜外分娩鎮痛可使第二產程及總產程延長、催產素使用率增加，但不增加急診剖宮產率和經陰道器械助產率，明顯降低瞭社會因素手術率，對分娩結跼無不良影響，用于縣鄉兩級醫院產婦是安全可行的。
목적：관찰현향량급의원산부행자공경막외분면진통대산정급분면결국적영향，평개현향량급의원산부행자공경막외분면진통적안전성여가행성。방법선택족월단태두위임신병경음도시산적초산부200례，균무경막외진통금기증，근거분면진통요구，장기납입진통조（P조，100례）급대조조（C조，100례）。기록량조제일、이산정급총산정시간，분면방식，산후출혈급최산소사용솔，신생인면출후1、5 min Apgar평분，분면진통적불량반응등。결과 P조교C조적제이산정화총산정현저연장，최산소사용솔P조명현고우C조；량조제일산정중전부궁산솔，기계조산솔，양수태분오염솔，신생인면출후1、5 min Apgar 평분，분면진통적불량반응균무통계학차이。결론경막외분면진통가사제이산정급총산정연장、최산소사용솔증가，단불증가급진부궁산솔화경음도기계조산솔，명현강저료사회인소수술솔，대분면결국무불량영향，용우현향량급의원산부시안전가행적。
Objective To assess the security and reliability of patient-controlled epidural labor analgesia in hospitals of county and township levels ,observing the effect of patient-controlled epidural labor analgesia on the duration of labor stages and deliv-ery outcome . Methods 200 cases of single cephalic pregnant primipara were assigned into epidural analgesia group (n=100) and control group(n=100) according to their request when no contraindications were present .Such as the stage Ⅰ ,stage Ⅱ ,to-tal duration of labor ,mode of delivery ,volume blood loss ,oxytocin dosage and after delivery ,neonatal 1 ,5 min score of Apgar , adverse reaction of labor analgesia ,all were recorded . Results In epidural analgesia group ,the duration of stage Ⅱ labor and the total duration of labor was significantly longer than those in the control group ,and the oxytocin usage rate of P group was significantly higher than C group .No significant difference was found between the two groups in the duration of stage Ⅰ ,emer-gency cesarean section ,instrumental delivery ,meconium-stained amniotic fluid ,neonatal 1 ,5 min score of Apgar and adverse re-action of labor analgesia . Conclusion Epidural labor analgesia prolongs the labor duration ,especially the stage Ⅱ ,but it does not increase the incidences of emergency cesarean section or instrumental delivery and does not cause adverse effect on neonatal outcome .Therefore ,patient-controlled epidural labor analgesia is security and reliable to generalize in hospitals of county and tow nship levels .
