目的: 探究硬膜外自控镇痛与关泵时机对产妇第二产程的影响。方法: 选取分娩的198例产妇作为观察对象,随机分三组,各66例,其中A组关闭镇痛泵时间为宫口开至8～9 cm时,B组关闭镇痛泵时间为宫口开全时,C组未行硬膜外自控镇痛,对比3组患者的镇痛效果及对产程及分娩结局的影响。结果: A、B两组患者的镇痛效果优于C组(P＜0.05),A、B两组患者第二产程长于C组(P＜0.05),A、B组患者第二产程比较差异有统计学意义(P＜0.05),其他指标比较差异无统计学意义(P＞0.05);3组患者的产后2 h出血量、新生儿Apgar评分、剖宫产率及其他临床结局指标比较,差异无统计学意义(P＞0.05)。结论: 硬膜外自控镇痛能对产妇分娩疼痛有效缓解,并于宫口开至8～9 cm时将镇痛泵关闭可缩短第二产程,且未对母婴结局产生不利影响。

Objective: To explore the influence of patient-controlled epidural analgesia and timing of pump closure on the second stage of maternal labor.Methods: 198 cases of maternal were selected as observation objects, and were randomly divided into three groups, with 66 cases in each group. In group A, the analgesic pump was closed when the cervix was open at about 8 ~ 9cm, in group B the analgesic pump was closed when the cervix was open completely, and in group C the epidural analgesia were not performed. The analgesic effect and the influence on labor stage and delivery outcome in the three groups were compared.Results: The analgesic effects in group A and B were significantly higher than that in group C, the second stage of labor was significantly longer than that in group C (P＜0.05). The second stage of labor in group A and B was significantly different (P＜0.05), but there were no significant differences in other indexes (P＞0.05); There were no significant differences in the 2h postpartum bleeding, neonatal Apgar score, cesarean section rate and other clinical outcome indexes between the three groups (P＞0.05).Conclusion: The patient-controlled epidural analgesia can relieve the pain of maternal, and can shorten the second stage of labor with the analgesia pump closed when the cervix was open at about 8 ~ 9cm. It has no adverse effects on maternal and neonatal outcomes.