摘要目的:观察持续硬膜外麻醉用于分娩镇痛的临床效果及其对妊娠结局的影响。方法:选择诸暨市妇幼保健院2017年7月至2018年6月住院分娩的产妇110例为观察对象，采用随机数字表法分为两组，对照组55例，采用常规处理；观察组55例，采用持续硬膜外麻醉分娩镇痛。比较两组产程时间、镇痛效果、分娩结局、不良反应发生情况、新生儿情况。结果:观察组活跃期时间(231.76±82.08)min、第二产程时间(63.94±22.56)min、总产程时间(309.42±120.15)min，均短于对照组[(275.62±85.31)min、(91.05±26.27)min、(380.84±121.63)min]，差异均有统计学意义( t＝2.748、5.806、3.098， P＝0.007、0.001、0.003)；观察组产妇的镇痛满意度为100.00%(55/55)，高于对照组的83.64%(46/55)，差异有统计学意义(χ 2＝9.802， P＝0.002)；观察组阴道出血量(241.62±30.54)mL、镇痛显效时间(62.80±11.96)s，均优于对照组[(270.55±40.83)mL、(135.18±20.73)s]，差异均有统计学意义( t＝4.208、22.429， P＝0.001、0.001)；观察组顺产率为87.27%(48/55)，高于对照组的70.91%(39/55)，差异有统计学意义(χ 2＝4.453， P＝0.035)；观察组新生儿窘迫发生率为1.82%(1/55)、窒息发生率为3.64%(2/55)，均低于对照组的12.73%(7/55)、16.36%(9/55)，差异均有统计学意义(χ 2＝4.853、4.950， P＝0.028、0.026)。 结论:在分娩镇痛中采用持续硬膜外麻醉可缩短产程且镇痛效果满意，有助于改善妊娠结局和新生儿状况。

abstractsObjective:To observe the clinical effect of continuous epidural anesthesia on labor analgesia and its effect on pregnancy outcome.Methods:From July 2017 to June 2018, 110 hospitalized women giving birth in the Maternal and Child Health Care Hospital of Zhuji were selected and randomly divided into two groups according to the digital table, with 55 cases in each group.The control group was given conventional treatment.The observation group was treated with continuous epidural anesthesia for labor analgesia.The duration of labor, analgesic effect, delivery outcome, adverse reactions and neonatal status were compared between the two groups.Results:The active time [(231.76±82.08)min], the second stage of labor [(63.94±22.56)min], and the total stage of labor [(309.42±120.15)min] in the observation group were all shorter than those in the control group[(275.62±85.31)min, (91.05±26.27)min, (380.84±121.63)min], and the differences were statistically significant( t=2.748, 5.806, 3.098, P=0.007, 0.001, 0.003). The analgesia satisfaction of the observation group was 100.00%(55/55), which was higher than 83.64%(46/55) of the control group, and the difference was statistically significant(χ 2=9.802, P=0.002). In the observation group, the amount of vaginal bleeding [(241.62±30.54)mL], analgesic effect time [(62.80±11.96)s] were better than those in the control group[(270.55±40.83)mL, (135.18±20.73)s], and the differences were statistically significant( t=4.208, 22.429, P=0.001, 0.001). The rate of natural birth in the observation group was 87.27%(48/55), which was higher than that in the control group[70.91%(39/55)], and the difference was statistically significant(χ 2=4.453, P=0.035). The incidence of neonatal distress in the observation group was 1.82%(1/55), and the incidence of asphyxia was 3.64%(2/55), which were lower than those in the control group [12.73%(7/55), 16.36%(9/55)], the differences were statistically significant(χ 2=4.853, 4.950, P=0.028, 0.026). Conclusion:Continuous epidural anesthesia in parturient analgesia can shorten the labor process and achieve satisfactory analgesic effect, which is helpful to improve the outcome of labor and neonatal condition.