可行走分娩镇痛对瘢痕子宫再次妊娠患者分娩结局的影响
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摘要
目的探讨可行走分娩镇痛对瘢痕子宫再次妊娠患者分娩结局的影响,为临床提供参考依据。方法将2016年8月-2017年11月于南通市妇幼保健院进行治疗的95例瘢痕子宫再次分娩患者作为研究对象,采用随机序列发生法对所有对象进行分组研究,其中对照组不予以镇痛处理,观察组采用可行走分娩镇痛处理。对比两组镇痛效果、产程时间、分娩结局、新生儿体质量及各项评分指标的差异。结果观察组产妇经镇痛处理后,其产后出血量、新生儿体质量、新生儿Apgar评分以及住院时间均与对照组比较,差异无统计学意义(P>0.05);两组各产程时间对比差异无统计学意义(P>0.05),观察组VAS评分显著低于对照组(P<0.05);观察组产妇经可行走分娩镇痛处理后不良反应较少,且与对照组比较,差异无统计学意义(P>0.05)。结论瘢痕子宫产妇再次妊娠经可行走分娩镇痛处理后,患者感受疼痛程度降低,且该麻醉方式对患者产后出血量、不良反应均无增加作用,新生儿质量无变化。
Objective To explore the effect of ambulatory labor analgesia on delivery outcome of patients with subsequent pregnancy after cesarean section,provide a reference basis for clinical treatment.Methods A total of 95 patients with subsequent pregnancy after cesarean section treated in Nantong Maternal and Child Health Care Hospital from August 2016 to November 2017 were selected as study object,then they were divided into two groups according to random sequence.The patients in control group were not treated with analgesia,while the patients in observation group were treated with ambulatory labor analgesia.The analgesic effects,labor duration time,delivery outcomes,neonatal weights,and the scores of all items were compared.Results After analgesic treatment,there was no statistically significant difference in the amount of postpartum hemorrhage,neonatal weight,neonatal Apagr score,and hospitalization time between observation group and control group(P>0.05).There was no statistically significant difference in the time of stages of labor between the two groups(P>0.05).VAS score in observation group was statistically significantly lower than that in control group(P<0.05).The adverse reactions after analgesic treatment in observation group decreased,compared with control group,there was no statistically significant difference(P > 0.05).Conclusion After analgesic treatment,the degree of pain in patients with subsequent pregnancy after cesarean section decreases,ambulatory labor analgesia has no effect on the amount of postpartum hemorrhage and adverse reactions,neonatal quality doesn't change.
Objective To explore the effect of ambulatory labor analgesia on delivery outcome of patients with subsequent pregnancy after cesarean section,provide a reference basis for clinical treatment.Methods A total of 95 patients with subsequent pregnancy after cesarean section treated in Nantong Maternal and Child Health Care Hospital from August 2016 to November 2017 were selected as study object,then they were divided into two groups according to random sequence.The patients in control group were not treated with analgesia,while the patients in observation group were treated with ambulatory labor analgesia.The analgesic effects,labor duration time,delivery outcomes,neonatal weights,and the scores of all items were compared.Results After analgesic treatment,there was no statistically significant difference in the amount of postpartum hemorrhage,neonatal weight,neonatal Apagr score,and hospitalization time between observation group and control group(P>0.05).There was no statistically significant difference in the time of stages of labor between the two groups(P>0.05).VAS score in observation group was statistically significantly lower than that in control group(P<0.05).The adverse reactions after analgesic treatment in observation group decreased,compared with control group,there was no statistically significant difference(P > 0.05).Conclusion After analgesic treatment,the degree of pain in patients with subsequent pregnancy after cesarean section decreases,ambulatory labor analgesia has no effect on the amount of postpartum hemorrhage and adverse reactions,neonatal quality doesn't change.
引文
[1]唐伟萍,江伟强.可行走分娩镇痛对瘢痕子宫再次妊娠患者分娩结局和婴儿结局的影响[J].中国医药科学,2017,7(2):96-98.
[2]Bogenkov K,Gustovarova T,Vinogradov V,et al.The effective and safety use of the epidural analgesia at vaginal delivery in the women with the uterine scar[J].J Obstet Gynaecol,2015,22(1):50-56.
[3]Barinov SV,Bindyuk AV,Ralko VV,et al.Prediction of vaginal delivery in pregnant women with a uterine scar[J].Oltrasound Obstet Gynecol,2016,16(1):51.
[4]王卫珍.瘢痕子宫再次妊娠经阴道分娩与剖宫产的母婴结局对比[J].临床合理用药杂志,2016,9(15):124-125.
[5]李香盛,魏秀举,王开勇.硬-脊联合麻醉不同阶段镇痛对足月产妇分娩结局的影响[J].热带医学杂志,2016,16(9):1141-1144.
[6]孟馨,李元涛,胡薇,等.持续硬膜外麻醉应用于临产孕妇的分娩镇痛效果及其对妊娠结局的影响[J].中国医学创新,2016,13(20):50-52.
[7]杨建敏,黄庆义.子宫瘢痕妊娠的诊治及预后[J].中国医药指南,2009,7(20):119-120.
[8]刘晓华,续云芳.剖宫产后瘢痕子宫再次妊娠经阴道分娩的母婴结局[J].中国性科学,2017,26(10):110-112.
[9]霍永清.瘢痕子宫再次妊娠不同分娩方式对母婴结局的影响[J].实用妇科内分泌电子杂志,2016,3(5):98-98.
[10]王永琴,魏兴武,段志良,等.可行走式分娩镇痛对子宫收缩及产程、分娩结局的影响分析[J].中国妇幼健康研究,2016,27(10):1248-1251.
[11]徐建武,林毅瑜.舒芬太尼对瘢痕子宫经阴道分娩患者镇痛效果及对分娩结局的影响[J].中国当代医药,2017,24(15):53-55.
[12]张茜茜,周雪微,董小琼.不同时机分娩镇痛对产妇母婴结局的影响[J].浙江临床医学,2017,19(1):85-86.
[13]刘月美,李智卿,容群.经产妇镇痛分娩应用时间对母婴结局的影响[J].现代诊断与治疗,2017,28(12):2317-2319.
[14]王艳.全程陪伴联合分娩镇痛对自然分娩产妇母婴结局的影响研究[J].现代诊断与治疗,2016,27(20):3919-3920.
[15]Floss K,Garciarocha GJ,Kundu S,et al.Fertility and pregnancy outcome after myoma enucleation by minilaparotomy under microsurgical conditions in pronounced uterus myomatosus[J].Geburt Frauen,2015,75(1):56-63.
[16]肖兰凤.分娩镇痛在临床中的应用及对母婴结局的影响[J].世界最新医学信息文摘:电子版,2016,16(1):72-73.
[17]翟利平,徐公元,邓爱华.不同时机实施硬膜外镇痛分娩对母婴结局的影响[J].中国妇幼保健,2017,32(15):3688-3690.
[18]曾雯琼,戚婷婷.连续硬膜外麻醉镇痛分娩对母婴结局的影响分析[J].按摩与康复医学,2016,7(16):34-35.
[2]Bogenkov K,Gustovarova T,Vinogradov V,et al.The effective and safety use of the epidural analgesia at vaginal delivery in the women with the uterine scar[J].J Obstet Gynaecol,2015,22(1):50-56.
[3]Barinov SV,Bindyuk AV,Ralko VV,et al.Prediction of vaginal delivery in pregnant women with a uterine scar[J].Oltrasound Obstet Gynecol,2016,16(1):51.
[4]王卫珍.瘢痕子宫再次妊娠经阴道分娩与剖宫产的母婴结局对比[J].临床合理用药杂志,2016,9(15):124-125.
[5]李香盛,魏秀举,王开勇.硬-脊联合麻醉不同阶段镇痛对足月产妇分娩结局的影响[J].热带医学杂志,2016,16(9):1141-1144.
[6]孟馨,李元涛,胡薇,等.持续硬膜外麻醉应用于临产孕妇的分娩镇痛效果及其对妊娠结局的影响[J].中国医学创新,2016,13(20):50-52.
[7]杨建敏,黄庆义.子宫瘢痕妊娠的诊治及预后[J].中国医药指南,2009,7(20):119-120.
[8]刘晓华,续云芳.剖宫产后瘢痕子宫再次妊娠经阴道分娩的母婴结局[J].中国性科学,2017,26(10):110-112.
[9]霍永清.瘢痕子宫再次妊娠不同分娩方式对母婴结局的影响[J].实用妇科内分泌电子杂志,2016,3(5):98-98.
[10]王永琴,魏兴武,段志良,等.可行走式分娩镇痛对子宫收缩及产程、分娩结局的影响分析[J].中国妇幼健康研究,2016,27(10):1248-1251.
[11]徐建武,林毅瑜.舒芬太尼对瘢痕子宫经阴道分娩患者镇痛效果及对分娩结局的影响[J].中国当代医药,2017,24(15):53-55.
[12]张茜茜,周雪微,董小琼.不同时机分娩镇痛对产妇母婴结局的影响[J].浙江临床医学,2017,19(1):85-86.
[13]刘月美,李智卿,容群.经产妇镇痛分娩应用时间对母婴结局的影响[J].现代诊断与治疗,2017,28(12):2317-2319.
[14]王艳.全程陪伴联合分娩镇痛对自然分娩产妇母婴结局的影响研究[J].现代诊断与治疗,2016,27(20):3919-3920.
[15]Floss K,Garciarocha GJ,Kundu S,et al.Fertility and pregnancy outcome after myoma enucleation by minilaparotomy under microsurgical conditions in pronounced uterus myomatosus[J].Geburt Frauen,2015,75(1):56-63.
[16]肖兰凤.分娩镇痛在临床中的应用及对母婴结局的影响[J].世界最新医学信息文摘:电子版,2016,16(1):72-73.
[17]翟利平,徐公元,邓爱华.不同时机实施硬膜外镇痛分娩对母婴结局的影响[J].中国妇幼保健,2017,32(15):3688-3690.
[18]曾雯琼,戚婷婷.连续硬膜外麻醉镇痛分娩对母婴结局的影响分析[J].按摩与康复医学,2016,7(16):34-35.