无痛分娩产妇生产期间导致产妇出现发热的影响因素与预防措施

摘要 目的：探讨无痛分娩产妇生产期间导致产妇出现发热的影响因素与预防措施。方法：选取我院2020年1月到2020年12月共收治的60例无痛分娩生产期间发热的产妇作为研究对象,将其分为观察组,另取同期60例无痛分娩生产期间未发生发热的产妇作为对照组。对所有产妇进行临床资料分析,对比两组产妇的人口学特征、妊娠基础疾病情况以及产时不同情况,并对所有相关因素进行多因素logistic回归分析。最后进行总结分析,并提出无痛分娩产妇生产期间发热的预防措施。结果：两组产妇的年龄、孕周、孕次、死胎史对比无明显差异（P＞0.05）,观察组产妇有保胎史的例数明显高于对照组,观察组产次明显低于对照组（P＜0.05）;两组产妇妊娠期贫血、妊娠期甲状腺功能异常、妊娠期高血压、妊娠期糖尿病、早产情况对比无明显差异（P＞0.05）,观察组胎膜早破产妇人数明显高于对照组（P＜0.05）;观察组产妇的第一产程时间、第二产程时间以及胎膜早破距离分娩时间明显高于对照组（P＜0.05）,观察组产妇的常规剂量罗哌卡因麻醉使用、人工破膜、宫缩素使用以及羊水污染人数明显高于对照组（P＜0.05）;对所有因素进行赋值,其中"是"或"有"为1,"否"或"无"为0,其他因素依照数值变量赋值。通过logistic回归分析发现,只有保胎史、产次、第一产程时间、第二产程时间、胎膜早破据分娩时间、硬膜外麻醉药物、宫缩素使用以及羊水污染为无痛分娩生产期间产妇发热的独立危险因素（P＜0.05）。结论：无痛分娩产妇的胎膜早破情况、破膜方式可能与产妇出现发热的情况具有一定相关性,但是只有保胎史、产次、第一产程时间、第二产程时间、胎膜早破据分娩时间、硬膜外麻醉药物、宫缩素使用以及羊水污染是产妇出现发热情况的独立危险因素,因此临床上要对初产妇、有保胎史、产程时间长、胎膜早破据分娩时间长、羊水污染等无痛分娩产妇给予一定预防措施,并调整硬膜外麻醉药物的使用,减少宫缩素使用,来避免无痛分娩产妇在生产期间出现的发热现象。

Influencing Factors and Preventive Measures of Fever during Painless Delivery

ABSTRACT Objective: To explore the influencing factors and preventive measures of fever during painless delivery. Methods: 60 cases of parturients with fever during painless childbirth in our hospital from January 2020 to December 2020 were selected as the research objects, and they were divided into the observation group, and another 60 cases of parturients without fever during painless childbirth in the same period were selected as the control group. Clinical data analysis was carried out for all the puerpera. The demographic characteristics, basic diseases of pregnancy and different conditions during labor of the two groups were compared, and all the related factors were analyzed by multivariate logistic regression. Finally, summarize and analyze, and put forward the prevention measures of painless childbirth maternal fever during production. Results: There was no significant difference in age, gestational weeks, times of pregnancy and stillbirth history between the two groups (P>0.05). The number of cases with history of fetal protection in the observation group was significantly higher than that in the control group, and the times of labor in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in anemia, thyroid gland dysfunction, hypertension, diabetes mellitus and premature delivery between the two groups (P>0.05), the number of pregnant women with premature rupture of membranes in the observation group was significantly higher than that in the control group (P<0.05); the time of the first stage of labor, the second stage of labor and the delivery time of premature rupture of membranes in the observation group were significantly higher than those in the control group (P<0.05); the number of pregnant women in the observation group with routine dose of ropivacaine anesthesia, artificial rupture of membranes, use of oxytocin and amniotic fluid pollution were significantly higher than those in the control group All factors were assigned values, in which "yes" was 1, and "no" was 0. Logistic regression analysis showed that only the history of fetal protection, times of labor, time of the first stage of labor, time of the second stage of labor, delivery time of premature rupture of membranes, epidural anesthetics, use of oxytocin and amniotic fluid pollution were the independent risk factors of maternal fever during painless delivery (P<0.05). Conclusion: The situation of premature rupture of membranes and the way of rupture of membranes may be related to the occurrence of fever, but only the history of fetal protection, the number of labor, the time of the first stage of labor, the time of the second stage of labor, the delivery time of premature rupture of membranes, epidural anesthetics, the use of oxytocin and amniotic fluid pollution are the independent risk factors of fever on the primipara, have a history of fetal protection, long duration of labor, premature rupture of membranes, long delivery time, amniotic fluid pollution and other painless childbirth maternal give certain preventive measures, and adjust the use of epidural anesthesia, reduce the use of oxytocin, to avoid painless childbirth maternal fever during production.