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目的 :评价第二产程延迟屏气对硬膜外分娩镇痛的初产妇分娩结局的影响。方法 :将我院行硬膜外分娩镇痛的初产妇400例,随机分为实验组和对照组各200例,实验组采取延迟屏气的方法,对照组按常规在宫口开全时即指导产妇屏气。结果 :实验组第二产程时间比对照组长,用力屏气时间比对照组短,差异均有统计学意义(P<0.01);两组分娩方式、新生儿体质量及Apgar评分、会阴裂伤及侧切率比较,差异均无统计学意义(P>0.05);实验组产后出血量比对照组少,产后30min和产后2h的疲劳程度比对照组轻,差异有统计学意义(P<0.01)。结论 :硬膜外分娩镇痛初产妇第二产程延迟屏气可有效缩短用力屏气时间和产后出血量,对母婴不会产生不利影响,并可减轻产后疲劳。
OBJECTIVE: To evaluate the effect of delayed breath-hold in the second stage of labor on delivery outcomes of early-onset women with epidural analgesia. Methods: 400 cases of primipara of epidural analgesia in our hospital were randomly divided into experimental group and control group with 200 cases each. The experimental group was treated with delayed breath-hold method. The control group was instructed regularly Maternal breath holding. Results: The length of the second stage of labor in the experimental group was longer than that in the control group, and the forced breath-hold time was shorter than that in the control group (P <0.01). The delivery modes, neonatal body weight and Apgar score, perineal laceration and (P> 0.05). The amount of postpartum hemorrhage in the experimental group was less than that in the control group. The post-natal 30min and post-natal 2h fatigue were lighter than those in the control group (P <0.01). Conclusion: Delayed breath-holding during the second stage of labor of epidural analgesia and primiparous women can shorten the time of forced breath-hold and the amount of postpartum hemorrhage effectively, which will not adversely affect the mother and infant and reduce post-partum fatigue.