山莨菪碱联合缩宫素对第一产程活跃期延长产妇产程及新生儿相关指标的影响

摘要

目的：探讨山莨菪碱联合缩宫素对第一产程活跃期延长产妇产程及新生儿相关指标的影响。方法：216例第一产程活跃期延长产妇随机分为对照组（108例）和观察组（108例）。两组产妇均进行人工破膜。在此基础上，对照组产妇给予注射用缩宫素2.5 u，溶于5％葡萄糖注射液500 ml中，静脉滴注（根据宫缩情况适当调整滴速）；观察组产妇在对照组用药的基础上给予盐酸消旋山莨菪碱10 mg，溶于5％葡萄糖注射液10 ml中，缓慢静脉推注5 min。两组产妇用药期间监护胎心，严密观察产程进展情况。观察两组产妇的宫颈成熟度、产程时间、分娩方式、产后情况和新生儿Apgar评分、体质量及不良反应发生情况。结果：观察组产妇宫颈成熟度≥9分的产妇例数、自然分娩率、新生儿5 min Apgar评分均显著高于对照组，7～＜9分、＜7分的产妇例数、剖宫产率、会阴侧/直切率、会阴裂伤率、产后24 h出血量均显著低于对照组，第二、第三及总产程时间均显著短于对照组，差异均有统计学意义（P＜0.05）。两组产妇潜伏期、第一产程活跃期、产钳助产率、新生儿体质量、不良反应发生率比较，差异均无统计学意义（P＞0.05）。结论：山莨菪碱联合缩宫素可加速第一产程活跃期延长产妇的宫口扩张，缩短产程，降低剖宫产率，改善产妇预后状况，不影响新生儿的体质量，且安全性相当。%OBJECTIVE:To investigate the effects of anisodamine combined with oxytocin on labor process of lying-in women with prolonged active phase in the first labor process and related indicators of newborns. METHODS:216 lying-in women with pro-longed active phase in the first labor process were randomly divided into control group(108 cases)and observation group(108 cas-es). All lying-in women were artificially ruptured,based on it,control group was given 2.5 u Oxytocin for injection,adding into 500 ml 5% Glucose injection by intravenous infusion,the drip rate was appropriately adjusted based on contractions;observation group was additionally given 10 mg raceanisodamine hydrochloride,adding into 10 ml 5% Glucose injection by intravenous infu-sion by 5 min slow intravenous injection. The fetal heart was warded to closely observe the labor process during medication. The cervical maturity,labor process time,delivery mode and postpartum situation of lying-in women,Apgar score,body mass and inci-dence of adverse reactions of newborn in 2 groups were observed. RESULTS:The lying-in women cases with no less than 9 cervi-cal maturity,natural delivery rate and 5 min newborn Apgar score in observation group were significantly higher than control group, lying-in women cases with 7-9 scores and less than 7 scores,cesarean section rate,perineal/ straight cut rate and 24 h postpartum hemorrhage were significantly lower than control group,the second,the third and total labor process were significantly shorter than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Anisodamine combined with oxytocin can accelerate the cervical dilation of lying-in women with pro-longed active phase,shorten labor process,reduce cesarean section rate and improve prognosis,it did not affect the body mass of newborns,with good safety.