| 耿墨钊,姜昊,车向明,姜海利.初产妇椎管内镇痛与分娩结局、第二产程时限分布的关系.[J].中南医学科学杂志.,2026,(1):63-66. |
| 初产妇椎管内镇痛与分娩结局、第二产程时限分布的关系 |
| The relationship between intradural analgesia in primiparous women and delivery outcomes, the distribution of the second stage of labor duration |
| 投稿时间：2025-03-31 修订日期：2025-10-22 |
| DOI：10.15972/j.cnki.43-1509/r.2026.01.014 |
| 中文关键词: 初产妇 EA 第二产程 分娩结局 |
| 英文关键词:primiparous women EA the second stage of labor delivery outcome |
| 基金项目:北京市卫生健康委员会首都卫生发展科研专项项目(2024-2-2116) 作者简介:耿墨钊,硕士,主治医师,研究方向为子痫前期、妊娠期糖尿病、胎儿生长受限等产科合并症、并发症的诊治,E-mail为obdgmz1727@ccmu.edu.cn。通信作者姜海利,博士,主任医师,硕士研究生导师,研究方向为围产保健、高危妊娠管理、产前诊断和胎儿医学,E-mail为jianghaili2020@ccmu.edu.cn。 |
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| 中文摘要: |
| 目的分析初产妇椎管内镇痛与分娩结局、第二产程时限分布的关系。 方法回顾性收集本院分娩的11 469例初产妇资料,依据是否实施椎管内硬脊膜外镇痛(EA),将其分为EA组(n＝6 382)和非EA组(n＝5 087)。比较两组一般资料、妊娠并发症、产程处理措施、妊娠结局、分娩结局及第二产程时限分布特征。 结果与非EA组比较,EA组产妇孕前体质指数≥28 kg/m2、妊娠期高血压疾病、子痫前期、人工破膜、使用缩宫素、新生儿Apgar低评分的比例以及宫内感染率、产后出血率、输血率、产钳助产率、产后出血量升高(P＜0.05)；新生儿出生体质量增加(P＜0.05)；第一产程时间、第二产程时间、总产程时间延长(P＜0.05)；第二产程≤1 h的产钳助产率、产后出血率、新生儿Apgar低评分比例和产后出血量以及第二产程1~2 h的产钳助产率升高(P＜0.05)。EA组第二产程1~4 h的产妇占比(41.4%)高于非EA组(21.4%；P＜0.05)。 结论初产妇椎管内镇痛与不良分娩结局风险升高和第二产程时限分布延后有关。 |
| 英文摘要: |
| AimTo analyze the relationship between intradural analgesia in primiparous women and delivery outcomes, as well as the distribution of the second stage of labor duration. MethodsThe data of 11 469 primiparous women who gave birth in our hospital was retrospectively collected, and they were divided into an EA group (n＝6 382) and a non-EA group (n＝5 087) based on whether spinal epidural block analgesia was implemented. The general information, pregnancy comorbidities, labor management measures, pregnancy outcomes, delivery outcomes, and distribution characteristics of the second stage of labor were compared between the two groups. ResultsCompared with the non-EA group, the EA group showed an increase proportion of pre-pregnancy body mass index ≥ 28 kg/m2, hypertensive disorders of pregnancy, preeclampsia, artificial rupture of membranes, use of oxytocin, newborns with low Apgar scores, intrauterine infection rate, postpartum hemorrhage rate, blood transfusion rate, forceps delivery rate, and postpartum bleeding volume (P＜0.05); The birth weight of newborns were increased (P＜0.05); The duration of the first stage of labor, second stage of labor, and total stage of labor were prolonged (P＜0.05); The rates of forceps assisted delivery, postpartum bleeding, proportion of newborns with low Apgar scores, and postpartum hemorrhage volume in the second stage of labor ≤1 h, and forceps assisted delivery at 1－2 h during the second stage of labor were increased (P＜0.05). The proportion of parturients in the EA group (41.4%) with a second stage of labor of 1－4 h was higher than that in the non-EA group (21.4%; P＜0.05). ConclusionIntraspinal analgesia in primiparous women is associated with an increased risk of adverse delivery outcomes and a delayed distribution of the second stage of labor. |
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