液体管理在自然分娩产程中的应用研究

Research on the application of different fluid management strategies in natural delivery

目的探寻安全、适宜的自然分娩产程中液体管理策略。方法选取2021年1月—2023年6月柳州市工人医院符合本研究纳入标准的初产妇311例,实施非静脉补液(进食半流质饮食)、口服补液+静脉补液、纯静脉补液的不同液体管理策略,统计分析三组的一般资料、入组前资料及入组结束时资料。结果各组产妇的总产程时长、中转剖宫产率、产后出血量、总尿量对比均无统计学差异(P>0.05),各组产妇在实施不同液体策略后,疲劳程度与口渴程度均有一定的缓解(P<0.05),其中纯静脉补液组缓解效果最明显。结论不同液体管理策略均能维持正常产程进展,产妇可适当进食、进水,必要时通过积极静脉补液补充足够的能量和水分,能有效缓解产妇疲劳程度与口渴程度,满足产妇自我需求和最佳舒适度,有利于子宫的正常收缩及产程进展,减少母儿不良结局的发生。

Objective To explore a safe and appropriate fluid management strategy during natural delivery.Methods A total of 311 primiparas were included who met the inclusion criteria of this study in Liuzhou Worker's Hospital from January 2021 to June 2023.They received different fluid management strategies,including no intravenous rehydration(eating semi-liquid diet),oral rehydration&intravenous rehydration,and intravenous rehydration.Comparative analysis was conducted on the general informations,pre enrollment datas,datas at the end of enrollment of the three groups.Results There were no significant differences in the total duration of labor,the rate of cesarean section,the amount of postpartum hemorrhage and the total urine volume between the three groups(P>0.05).The degrees of fatigue and thirst were relieved after the implementation of different fluid strategies in the three groups(P<0.05),and the effect of pure intravenous rehydration group was the most obvious.Conclusion Different fluid management strategies can maintain the normal progress of labor.Puerperas can eat more food and water,receive actively supplement enough energy and water through the vein when necessary,which can effectively alleviate the degrees of maternal fatigue and thirst,meet the self-demand and comfort of the puerpera.It is conducive to the normal contraction of the uterus and the progression of labor,and reduce the occurrence of maternal and fetal adverse outcomes.