摘要【目的】探讨无痛分娩产妇认知障碍发生现状及其影响因素。【方法】回顾性分析2019年7月至2020年3月在延安市人民医院进行无痛分娩的185例产妇的临床资料,统计无痛分娩产妇认知障碍发生情况,并收集产妇文化程度、镇痛方式、产程等一般资料,采用多因素Logistic回归分析无痛分娩产妇发生认知障碍的独立危险因素。【结果】185例无痛分娩产妇中,32例产后继发认知功能障碍,占17.30%;未发生认知功能障碍153例,占82.70%。多因素Logistic回归分析显示:镇痛方式(OR=1.422,95%CI=1.857～1.978)、新生儿转科(OR=3.267,95%CI=1.473～1.588)、产前匹兹堡睡眠质量指数(PSQI)(OR=1.472,95%CI=1.176～1.385)、宫开3 cm时视觉模拟量表(VAS)评分(OR=1.525,95%CI=1.252～1.402)、宫开10 cm VAS评分(OR=1.643,95%CI=1.511～1.671)是无痛分娩产妇发生认知障碍的独立危险因素。【结论】镇痛方式、新生儿转科、产前PSQI评分及宫开3 cm、10 cm VAS评分是无痛分娩产妇发生认知障碍的影响因素,而有效镇痛可降低产后认知功能障碍发生风险。
Abstract：【Objective】To study the current situation and influencing factors of cognitive impairment in painless delivery. 【Methods】From July 2019 to March 2020,185 parturients who had painless delivery in Yan'an People's Hospital were included as the research subjects. A retrospective analysis was carried out. The incidence of cognitive impairment in painless delivery women was statistically analyzed. General data such as maternal education level,analgesia mode and labor process were collected. The independent risk factors of cognitive impairment in painless delivery women were analyzed by multivariate logistic regression analysis. 【Results】Among the 185 painless delivery,32 cases had postpartum cognitive impairment,accounting for 17.30%; 153 cases had no cognitive impairment,accounting for 82.70%. Multivariate logistic regression analysis showed that analgesia(OR=1.422,95%CI=1.857～1.978),neonatal transfer(OR=3.267,95%CI=1.473～1.588),prenatal Pittsburgh sleep quality index (PSQI)(OR=1.472,95%CI=1.176～1.385),visual analogue scale (VAS) score at uterine dilation 3 cm(OR=1.525,95%CI=1.252～1.402),and the VAS at uterine dilation 10 cm(OR=1.643,95%CI=1.511～1.671) were independent factor of cognitive impairment in painless delivery. 【Conclusion】Methods of analgesia,transfer of neonate,PSQI score before delivery,3 cm VAS scores and 10 cm VAS score of uterine dilation are the influencing factors of cognitive impairment in painless delivery,while effective analgesia can reduce the risk of cognitive impairment after delivery.
李霞, 李君亮, 赵婧. 无痛分娩产妇认知障碍发生现状及其影响因素分析[J]. 医学临床研究, 2023, 40(2): 223-225.
LI Xia, LI Jun-liang, ZHAO Jing. Study on the Current Situation and Influencing Factors of Cognitive Impairment in Painless Delivery. JOURNAL OF CLINICAL RESEARCH, 2023, 40(2): 223-225.
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2023, Vol. 40 
