【摘要】：目的:探討新產(chǎn)程標(biāo)準(zhǔn)管理下硬膜外阻滯分娩鎮(zhèn)痛產(chǎn)婦第二產(chǎn)程時(shí)長(zhǎng)對(duì)新生兒Apgar評(píng)分及臍動(dòng)脈血?dú)夥治龅鹊挠绊�。方�?回顧新產(chǎn)程標(biāo)準(zhǔn)在我院實(shí)行2年以來(lái)(2014年10月至2016年9月)第二產(chǎn)程持續(xù)時(shí)間≥3h的單胎、足月、頭先露、無(wú)合并癥初產(chǎn)婦且行硬膜外阻滯分娩鎮(zhèn)痛的病例,去除死胎引產(chǎn)、胎兒畸形、前置胎盤、中轉(zhuǎn)剖宮產(chǎn)病例,滿足條件共91例為研究組(A組),根據(jù)第二產(chǎn)程持續(xù)時(shí)間長(zhǎng)短將其分為3組:3~3.5h,共51例設(shè)為A1組;3.5~4h,共25例為A2組;≥4h,共15例為A3組。隨機(jī)抽取同期在硬膜外阻滯分娩鎮(zhèn)痛下陰道分娩且第二產(chǎn)程3h的符合入組條件的病例共160例作為對(duì)照組(B組)�；仡櫜⑹占�4組產(chǎn)婦的病歷資料,將A1組、A2組、A3組的新生兒Apgar評(píng)分及臍動(dòng)脈血?dú)夥治鼋Y(jié)果與B組進(jìn)行比較。結(jié)果:A1組新生兒低Apgar評(píng)分發(fā)生率高于B組(P0.05),臍動(dòng)脈血?dú)夥治黾稗D(zhuǎn)科治療情況與B組相比無(wú)明顯差異(P0.05)。A2組低1分鐘Apgar評(píng)分(16%)、低5分鐘Apgar評(píng)分(4%)發(fā)生率明顯高于B組(分別為4.4%,0.6%)(P0.05);A2組臍動(dòng)脈血?dú)夥治鯷pH 7.185±0.11,BE值(-5.81±3.1)mmol/L,乳酸(5.23±1.9)mmol/L]與B組[pH 7.275±0.08,BE值(-3.51±3.3)mmol/L,乳酸(2.95±3.1)mmol/L]相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05),新生兒轉(zhuǎn)科率高于A1組及B組;A3組低1分鐘Apgar評(píng)分(46.7%)及低5分鐘Apgar評(píng)分(26.7%)發(fā)生率明顯高于B組及A1、A2組(P0.01);臍動(dòng)脈血?dú)夥治鯷pH 7.135±0.08,BE值(-8.55±0.9)mmol/L,乳酸(7.85±1.5)mmol/L)]與B組及A1、A2組相比有顯著差異(P0.01),新生兒轉(zhuǎn)科及NICU率明顯增加。結(jié)論:硬膜外阻滯分娩鎮(zhèn)痛下第二產(chǎn)程3h新生兒低Apgar評(píng)分發(fā)生率升高;新生兒臍動(dòng)脈血p H值下降,BE負(fù)值增大,乳酸含量增加,尤其第二產(chǎn)程≥3.5h后變化明顯;新生兒短期不良結(jié)局發(fā)生率升高。
[Abstract]:Aim: to investigate the effect of epidural block on neonatal Apgar score and umbilical artery blood gas analysis in the second stage of labor analgesia under the standard management of new labor process. Methods: to review the cases of single fetus with duration of more than 3 hours in the second stage of labor since 2 years (from October 2014 to September 2016) in our hospital, who showed their heads first and did not have complications, and received epidural block for labor analgesia, and all the cases were performed with epidural block in the first trimester of labor in our hospital for 2 years (from October 2014 to September 2016). 91 cases of stillbirth induction, fetal malformation, placenta previa, and conversion to cesarean section were divided into three groups according to the duration of the second stage of labor: 3) 3.5 hours, 51 cases were set up as A1 group, and 91 cases were treated as study group (group A) according to the duration of the second stage of labor. There were 25 cases of A2 group and 15 cases of A3 group (鈮，

本文編號(hào)：2450765