持续硬膜外阻滞分娩镇痛对产程的影响

目的：探讨持续硬膜外阻滞分娩镇痛（以下简称分娩镇痛）对产程的影响，为分娩镇痛产程的观察和护理提供临床依据。方法：选择分娩镇痛产妇230例和非分娩镇痛的产妇210例，比较两组产妇生产过程的疼痛度、配合度、满意度。分析两组的官缩特点，比较两组之间产程时间上的区别。结果：分娩镇痛组在生产过程的舒适度、配合度、满意度等方面远远高于非分娩镇痛组（P〈O．05）。镇痛组宫缩各项指标与未镇痛组比较，有明显差异（P〈0．05）。胎儿以非枕前位入盆的产妇，分娩镇痛组的第一产程时间长于非分娩镇痛组（P〈0．05）；当产妇出口横径〈胎儿双顶径时，分娩镇痛组的第二产程时间长于非分娩镇痛组（P〈O．05）。结论：分娩镇痛延长了以非枕前位人盆的产妇的第一产程时间和出口横径〈胎儿双顶径产妇的第二产程时间，但并不会影响所有产妇的产程时间，所以分娩镇痛的产程需要仔细观察，区别化处理。

Effects of continuous epidural anesthesia on stage of labor.

To investigate the effect of continuous epidural blockade labor analgesia on the labor and to provide clinical evidence for labor observation and nursing. Methods：The data were collected from 230 puerpera who received the labor analgesia with informed consent and 210 puerpera who didn＇t choose the labor analgesia. The measurements of pain level, cooperation degree, and satisfaction during labor were compared between these two groups. The characteristics of uterine contractions, stages of labor and labor time were observed and compared between two groups. Results ： The labor analgesia group got far better outcomes than no analgesia group in comfort, cooperation level and satisfaction （ P 〈 0.05 ）. The index of uterine contractions were statistically different between two groups （ P 〈 0.05 ）. The first - stage - of labor in labor - analgesia group was longer than that in no analgesia group when the fetus went into the pelvic with non - occipital anterior. When maternal transverse outlet diameter was less than fetal biparietal diameter, the second - stage - of - labor in labor - analgesia group was longer than that in no analgesia group with statistical difference （ P 〈 0.05 ）. Conclusion ： Labor analgesia extended the first stage of labor when fetus went into the pelvic with non - occipital anterior and extended the second stage of labor when maternal transverse outlet diameter was less than fetal biparietal diameter. But the labor analgesia had no influence on labor stages in parturient without above factors. So the stage of labor should be observed carefully and managed individually when labor analgesia is used.