目的 探讨在催产素引产过程中分娩镇痛时机和镇痛方式对妊娠结局的影响。方法 选取2020年1月—2020年7月上海市普陀区妇婴保健院有分娩镇痛需求的催产素引产产妇共260例,随机分为两组,硬膜外早置管分娩镇痛组（130例）,常规硬膜外分娩镇痛组（130例）,比较两组的分娩结局、产程时间、侧切率、产后出血量及视觉模拟评分法（visual analogue scale/score,VAS）评分。结果 早置管镇痛组产妇的镇痛前VAS评分明显低于常规镇痛组（7.82±0.92对8.34±0.83,P<0.05）,虽然早置管镇痛组置管后的VAS评分略高于常规镇痛组（4.60±0.75对4.19±0.85,P<0.05）,但加药以后的疼痛评分与常规镇痛组无明显差异（3.91±0.71对3.88±0.69,P>0.05）,两组的产程时间、侧切率及产后出血量、产钳助产率及剖宫产率无明显差异。结论 早置管镇痛可在产程初期,VAS评分较低时缓解宫缩痛,同时不影响产程进展,不增加出血率、侧切率、阴道助产率及剖宫产率,不降低新生儿评分,缓解产妇不良情绪,提高阴道分娩质量,值得推广。

Objective To investigate the effect of timing and mode of labor analgesia during labor induction with oxytocin on pregnancy outcome. Methods A total of 260 parturients requiring labor analgesia induced by oxytocin in Shanghai Putuo District Maternal and Child Health Hospital from January to July 2020 were randomly divided into an early catheterization analgesia group （n=130） and a routine analgesia group （n=130） according to labor analgesia program. The delivery outcome, duration of labor, lateral incision rate, amount of postpartum hemorrhage, and Visual Analogue Scale （VAS） score were compared between the two groups. Results The VAS score before analgesia in the early catheterization analgesia group was significantly lower than that in the routine analgesia group （7.82±0.92 vs. 8.34±0.83, P<0.05）. Although the VAS score after catheterization in the early catheterization analgesia group was slightly higher than that in the routine analgesia group （4.60±0.75 vs. 4.19±0.85, P<0.05）, there was no significant difference in the score after analgesia between the two groups （3.91±0.71 vs. 3.88±0.69, P>0.05）. There were no significant differences in the time of labor, the rate of lateral incision,the amount of postpartum hemorrhage, the rate of forceps delivery, and the rate of cesarean section between the two groups. Conclusion Early catheterization analgesia can relieve uterine contraction pain in the early stage of labor when the VAS score is low, while not affecting labor, not increasing the bleeding rate, lateral incision rate, vaginal delivery rate, and cesarean section rate, and not reducing the neonatal score. It helps relieve the negative mood of pregnant women, and improve the outcome of vaginal delivery,thus is worth popularizing.