硬膜外分娩镇痛相关产时发热影响因素分析Analysis of influencing factors of epidural-related maternal fever
梅洪梁;谢菡;张海霞;葛卫红;戴毅敏;
摘要(Abstract):
目的:研究接受自控硬膜外镇痛(PCEA)分娩的产妇发生硬膜外分娩镇痛相关产时发热(ERMF)的影响因素。方法:回顾分析2019年4月至2020年8月在南京大学医学院附属鼓楼医院接受PCEA分娩镇痛的387例产妇的临床资料。根据产妇是否发生ERMF分为2组:ERMF组(81例)、对照组(306例),比较两组间基本信息、妊娠合并症、产前用药、PCEA时宫口扩张、产时情况、视觉模拟评分法(VAS)的疼痛评估、满意度和新生儿Apgar评分,并进行二元logistic回归分析。结果:二元logistic分析显示,PCEA时宫口扩张程度小(OR=1.402,95%CI为1.049~1.874,P=0.022)是ERMF的危险因素,增加产妇ERMF发生风险。总产程时间短(OR=0.848,95%CI为0.785~0.915,P=0.000)、产前应用抗菌药物(OR=0.425,95%CI为0.238~0.760,P=0.004)、产前应用硫酸镁(OR=0.215,95%CI为0.060~0.766,P=0.018)是ERMF的保护因素,降低产妇ERMF的发生风险。ERMF的发生未影响产妇对PCEA分娩镇痛效果的满意度和新生儿Apgar评分(P>0.05)。结论:ERMF的影响因素包括PCEA时宫口扩张程度、总产程、产前应用抗菌药物和硫酸镁。可据此对ERMF高危产妇进行初步预判,在产程中密切监测产妇体温,提前准备好母体和胎儿的处置措施,便于ERMF发生时的及时处理。
关键词(KeyWords): 分娩镇痛;自控硬膜外镇痛;硬膜外分娩镇痛相关产时发热;相关因素;logistic回归分析
基金项目(Foundation): 南京药学会-常州四药医院药学科研基金资助课题(No:2021YX004);; 国家自然科学基金资助项目(No:81903870);; 江苏省药学会-恒瑞医院药学基金科研项目(No:H202107)
作者(Authors): 梅洪梁;谢菡;张海霞;葛卫红;戴毅敏;
DOI: 10.13283/j.cnki.xdfckjz.2022.02.001
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