目的:探究与分析妊娠期高血压疾病产妇不同分娩镇痛时机对产程、分娩方式及新生儿的影响.方法:回顾性分析江西省妇幼保健院自 2021 年 1 月—2022 年 6 月收治的 282 例妊娠期高血压疾病产妇的临床资料,按照子宫口直径是否≥3 cm可分为Ⅰ组(154 例)及Ⅱ组(128 例),Ⅰ组在分娩潜伏期(子宫口直径<3 cm)时实施镇痛,Ⅱ组在分娩活跃期(子宫口直径≥3 cm且<5 cm)时实施镇痛,采用视觉模拟评分法(VAS)对不同时间段疼痛程度进行评价,同时对比两组的分娩方式、新生儿情况及不良反应.结果:两组分娩潜伏期VAS评分比较,Ⅰ组评分低于Ⅱ组,差异有统计学意义(P<0.05).两组镇痛前、分娩活跃期及第二产程评分比较,差异均无统计学意义(P>0.05).两组分娩方式及新生儿情况比较,差异均无统计学意义(P>0.05).两组产妇不良反应发生率比较,差异均无统计学意义(P>0.05).结论:在妊娠期高血压疾病产妇的分娩潜伏期实施镇痛不会对产程造成不良影响,会在一定程度上降低分娩潜伏期的疼痛程度,未增加产妇不良反应发生率,安全性有保障.
Objective:To explore and analyze the effects of different timing of labor analgesia on stages of labor,delivery mode and conditions of the newborn in pregnant women with gestational hypertension.Method:The clinical data of 282 puerperae with hypertensive disorder of pregnancy admitted to Jiangxi Maternal and Child Health Hospital from January 2021 to June 2022 were retrospectively analyzed.According to whether the uterine mouth diameter was≥3 cm,they were divided into group Ⅰ(154 cases)and group Ⅱ(128 cases).Group Ⅰ in the latent period of labor(uterine mouth diameter was<3 cm)implemented analgesia,group Ⅱ in the active period of labor(uterine mouth diameter was≥3 cm and<5 cm)implemented analgesia.The visual analogue scale(VAS)was used to evaluate the degree of pain at different time points.At the same time,the delivery mode,conditions of the newborn and adverse reactions were compared between the two groups.Result:VAS scores of latent period of labor of the two groups were compared,the score in group Ⅰ was lower than that in group Ⅱ,the difference was statistically significant(P<0.05).There were no significant differences in the scores before analgesia,during active period of labor and the second stage of labor between the two groups(P>0.05).There were no significant differences in delivery mode and conditions of the newborn between the two groups(P>0.05).There were no significant differences in the incidences of adverse reactions between the puerperae in two groups(P>0.05).Conclusion:Analgesia in the latent period of labor for puerperae with hypertensive disorder of pregnancy will not cause adverse effects on the stages of labor.It can reduce the degree of pain in the latent period of labor to a certain extent,and does not increase the incidence of adverse reactions of puerperae,the safety is guaranteed.