枕横位及枕后位产妇在无痛分娩待产中体位管理的对照研究

A comparative study on body position management for parturient women undergoing painless labor with occipital transverse position and occiput posterior position

目的探讨无痛分娩枕横位及枕后位产妇待产过程中实施对侧卧位体位管理对产妇生产方式及新生儿情况的影响。方法选取2016年2月~2018年2月于我医院进行住院生产的60例初产妇作为研究对象,依据完全随机分组方法分为观察组和对照组各30例,对照组患者开展常规自然分娩法,观察组产妇接受无痛分娩术联合体位管理。对两组产妇的产程时间、生产方式、新生儿并发症发生情况,新生儿Apgar评分进行统计学计算和分析。结果观察组产妇第一产程及第二产程时间相比对照组显著更少,差异有统计学意义(P <0.05),而两组产妇第三产程时间比较,差异无统计学意义(P> 0.05);观察组产妇自然分娩率相比对照组更高,差异有统计学意义(P <0.05);观察组新生儿并发症发生率与对照组相比明显更低,差异有统计学意义(P <0.05);观察组新生儿Apgar评分与对照组相比明显更高,差异有统计学意义(P <0.05)。结论枕横位、枕后位产妇行腰硬联合麻醉无痛分娩待产过程中,为其实施对侧卧位体位管理可有效缩短产妇产程,提升产妇自然分娩率,还可有效规避新生儿并发症,提升新生儿Apgar评分,对母婴健康具有积极影响,因此该种方法值得在临床中进行推广。

Objective To explore the effect of lateral position management on maternal delivery methods and neonatal conditions for parturient women undergoing painless labor with occipital transverse position and occiput posterior position. Methods 60 primipara hospitalized in Huazhou People’s Hospital of Guangdong Province from February 2016 to February 2018 were selected as research objects.According to the completely randomized grouping method,they were divided into the observation group and the control group,with 30 cases in each group.Patients in the control group were given routine natural delivery while patients in the observation group were given painless labor combined with body position management.The time of labor, delivery methods,neonatal complications and neonatal Apgar scores were statistically calculated and analyzed. Results The first stage of labor and the second stage of labor in the observation group were significantly less than those in the control group.There was a statistically significant difference between the groups(P < 0.05),while the third stage of labor in the two groups had no significant difference and the difference had no statistical significance(P > 0.05).The natural delivery rate of the observation group was higher than that of the control group and the difference between two groups was statistically significant(P < 0.05).The incidence of neonatal complications in the observation group was significantly lower than that in the control group.There was a statistically significant difference between the groups(P < 0.05).The neonatal Apgar score in the observation group was significantly higher than that in the control group and the difference was statistically significant(P < 0.05). Conclusion For parturient women with occipital transverse position and occiput posterior position undergoing painless labor by combined spinal and epidural anesthesia,lateral position management can effectively shorten the stage of labor,improve natural delivery rate,effectively avoid neonatal complications and improve neonatal Apgar score.It has a positive effect on maternal and child health,so this method is worthy of promotion in the clinical practice.