摘要
目的探讨6-4-3产程管理模式联合硬膜外分娩镇痛单次给药对产程的影响。方法回顾性分析选取2015至2016年自然临产的324例产妇作为研究对象。按自然临产时间随即分为A、B、C组,每组108例。A组:孕妇采用"6-4-3"产程管理,应用硬膜外分娩镇痛单次给药。B组:孕妇旧产程管理,应用硬膜外分娩镇痛单次给药。C组:孕妇采用"6-4-3"产程管理,应用硬膜外分娩镇痛,自控泵多次给药。比较3组孕妇母儿结局。结果 A、C组活跃期平均时间较B组明显缩短,活跃期停滞发生率明显下降(P<0.05)。C组第二产程时间明显长于A、B组,A、C组的剖宫产率明显低于B组,阴道助产、侧切率、产后出血、尿潴留、产褥病率、侧切口感染等情况也明显增加(P<0.05)。C组的镇痛药物用量明显多于前2组,但镇痛效果3组无明显区别。结论 6-4-3产程管理模式与硬膜外复合镇痛在临床应用后剖宫产率、阴道助产率显著降低,减少医疗干预和分娩并发症,节约医疗成本,对新生儿短期预后无影响,达到促进自然分娩的目的。
Objective To explore the effects of 6-4-3 birth process management mode combined with epidural analgesia by single-dose medication on birth process. Methods A total of 324 parturients who underwent natural delivery in our hospital from 2015 to 2016 were enrolled as research objects. According to natural delivery time,these parturients were randomly divided into groups A,B,and C,with 108 parturients in each group. The pregnant women in group A were treated by ＂6-4-3＂birth process management mode with a single dose of epidural labor analgesia. The pregnant women in group B were treated by traditional birth process management mode,and the pregnant women in group C were treated by＂6-4-3＂birth process management mode with multiple dosing of epidural analgesia by automatic control pump. The maternal and fetal outcomes were observed and compared among the three groups. Results The mean time of active phase in group A and group C was significantly shorter than that in group B（ P〈 0. 05）,and the incidence rate of protracted active phases in group A and C was significantly lower than that in group B（ P〈 0. 05）. The second stage of labor time in group C was significantly longer than that in group A and group B（ P〈 0. 05）. Moreover cesarean section rate in group A and C was significantly lower than that in group B,however the incidence rates of vaginal midwifery,episiotomy rate,postpartum hemorrhage,urinary retention,puerperal morbidity,lateral incision infection in group A and C were significantly increased in group B（ P〈 0. 05）. In addition the dosage of analgesic drugs in group C was significantly inreased,as compared with that in group A and B,but there were no significant differences in analgesic effects among the three groups. Conclusion After the clinical application of 6-4-3 birth process management mode and epidural analgesia,the rate of cesarean section and vaginal delivery can be decreased significantly. It can reduce medical intervention and childbirth complications,save medical cost and has no effect on the new and short-term prognosis,and can achieve the purpose of promoting natural childbirth.
作者
张秋萍
杨秋玲
ZHANG Qiuping;YANG Qiuling(Birthing Centers of Jizhou District Hospital,Hebei,Hengshui 053200,Chin)
出处
《河北医药》
CAS
2018年第12期1859-1862,共4页
Hebei Medical Journal
关键词
6-4-3产程
剖宫产
阴道助产
硬膜外分娩镇痛
单次给药
6-4-3 birth process
cesarean section
vaginal delivery
epidural labor analgesia
single medication
