| [Objective] To investigate the clinical outcome of the patient controlled epidural analgesia(PCEA)on delivery process,delivery outcome and the effect on the mother and infant in the process of natural delivery by collecting and analyzing the related data during the delivery,so as to provide theoretical reference for carrying out labor analgesia in an all-round way.[Methods] By consulting the medical history data,we selected 400 pregnant women who met the inclusion and exclusion criteria from May 2019 to January 2020 in our hospital,200 of them were in the test group(PCEA was required)and 200 were in the control group(without PCEA).The PCEA was used when the cervix opening was larger than 3 cm in the study group and no analgesic measures were used in the control group.The general information,the transit cesarean section rate,the vaginal delivery rate,the exogenous oxytocin utilization rate,the birth process,the visual analogue scale(VAS),the rate of fever,the catheterization rate,the postpartum urinary retention rate,the postpartum hemorrhage rate,incidence of fetal distress,neonatal 1 min and 5 min Apgar score of two groups and the risk factors of intrapartum fever were compared and analyzed.[Results]1.General data comparison: there was no significant difference in height,weight,age,gestational weeks and the time between rupture of membrane and the end of delivery between the study group and the control group(P > 0.05).2.Delivery mode comparison: The rate of conversion of cesarean section in the test group was 17% and the rate of vaginal delivery mode was 3%.The rate of conversion of cesarean section was 25%,the rate of vaginal delivery mode was 4% in the control group.The rate of conversion of cesarean section in the study group was lower than that in the control group,the difference was statistically significant(P < 0.05).There was no significant difference in the rate of vaginal delivery between the two groups(P > 0.05).3.The utilization rate of oxytocin: The utilization rate of oxytocin in the test group and thecontrol group was 49.5% and 10.5%,respectively.There was significant difference between the two groups(P < 0.001).4.The comparison of the labor stage: In the test group,the first stage of labor was 486.73 ±184.70 min,the second stage was 76.84 ± 47.11 min,the third stage was 5.99 ± 5.12 min.In the control group,the first stage was 288.82 ± 192.94 min,the second stage was 39.49 ±32.84 min,the third stage was 5.47 ± 4.33 min.The time of the first and second stages of labor in the test group was longer than that in the control group(P < 0.001),and there was no significant difference for the time of third stage between the two groups(P > 0.05).5.The comparison of the VAS score : It can be seen from the curve that the VAS score of the study group decreased from more than 8 points to less than 3 points after PCEA,and the VAS score of the control group remained at more than 8 points,with significant difference between the two groups.6.The comparison of postpartum hemorrhage: The amount of postpartum hemorrhage was301.93 ± 89.21 ml and the incidence of postpartum hemorrhage was 4.5% in the study group.The amount of postpartum hemorrhage was 314.34 ± 85.33 ml,the incidence of postpartum hemorrhage was 5% in the control group.There was no significant difference between the two groups(P > 0.05).7.The comparison of fever rate during childbirth: The fever rate during childbirth in the study group was 11.5%,while that in the control group was 3%.The fever rate during childbirth in the study group was significantly higher than that in the control group(P <0.001).The results showed that PCEA(OR = 7.046,95% CI: 2.120 ? 24.031,P < 0.05)and labor time(OR = 1.023,95% CI: 1.001 ? 1.065,P < 0.05)were the related risk factors of maternal fever.8.The incidence of catheterization and postpartum urinary retention: In the study group the rate of catheterization was 50% and the control group was 18%,the study group was significantly higher than the control group(P < 0.001).The incidence of postpartum urinary retention in the study group was 3% and the incidence of postpartum urinary retention in the control group was 1.9%,although the incidence of the study group was slightly higher,the difference was not statistically significant(P>0.05).9.The comparison of fetal distress rate and neonatal Apgar score: The incidence of fetal distress in the study group was 14.5%,that in the control group was 16%,and there was no statistical difference between the two groups(P > 0.05);the Apgar score of 1 min / 5 min inthe study group was(9.6 ± 0.4)/(9.8 ± 0.5),that in the control group was(9.5 ± 0.5)/(9.7 ±0.6),there was no statistical difference between the two groups(P>0.05).[Conclusion]1.The PCEA has significant analgesic effect in the process of natural delivery.It can reduce the rate of cesarean section and has no adverse effect on the fetus and newborn.It is safe and reliable with few adverse effect.2.Compared with the natural labor without analgesic measures,PCEA can prolong the first and second labor process,but the labor process in the normal range;PCEA can increase the use rate of exogenous oxytocin,the rate of fever during labor and the rate of catheterization,but it has no adverse effect on the outcome of labor.3.The PCEA is beneficial to comfortable delivery in the process of natural delivery,which has obvious advantages and is worthy of clinical promotion. |
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