初产妇应用拉玛泽减痛分娩法效果观察

Effect of Lamaze method for pain-relieving delivery in primiparas

目的观察拉玛泽减痛分娩法在初产妇分娩中的效果。方法选取初产妇181例为对照组，在孕5～9月期间不接受拉玛泽减痛分娩法训练，分娩时通过产程常规护理并施用导乐陪伴来助产；另选取228例为观察组，在孕5～9月期间，在丈夫陪伴下，每天用20～30分钟，共同进行拉玛泽减痛分娩法，主要包括神经肌肉控制、呼吸力量技巧、注意力转移的专项训练，分娩时除导乐陪伴外，严格执行拉玛泽减痛分娩法护理技术规范。对两组阴道分娩产程时间、分娩方式、分娩疼痛分级进行比较。结果两组第一产程、总产程时间比较差异有极显著性（u值分别为27．54、21．14，P均〈0．01）；分娩方式中顺产、剖宫产差异有极显著性（χ^2值分别为22．76、18．83，P均〈0．01）；疼痛分级中0～3级差异均有及显著性（χ^2值分别为14．11、17．14、43．12、15．44，P均〈0．01）。结论初产妇应用拉玛泽减痛分娩法，可以缩短产程时间，较好地减轻分娩疼痛程度，有力地促进自然分娩，是一种值得优先推荐的分娩法。

Objective To observe the effect of Lamaze method for pain-relieving delivery in primiparas. Methods A total of 181 primiparas were chosen to the control group. The women in this group did not receive Lamaze method for pain-relieving delivery during a gestational age 5 to 9 months and routine labor nursing and Doula assistance were used during labor and delivery. 228 primiparas were assigned to the study group. They practised Lamaze method including neuromuscular control, breathing skills, and attention shift 20 to 30rain daily with their husbands; in addition to Doula assistance, the nursing practice of Lamaze method were strictly performed during labor and delivery. The duration of vaginal delivery, labor patterns, and degrees of labor pain were compared between the two groups. Results There were significant differences in the process of the first stage and the total childbirth process between the two groups （ u = 27.54 and u = 21.14, P 〈 0.01 for both comparisons ）. The differences between natural labor and Caesarean birth had statistical significance （ χ2= 22.76 and χ2= 18.83, P〈 0.01 for both comparisons ）. The differences in the pain levels 0 to 3 had statistical significance （ χ2 = 14.11, χ2= 17.14, χ2= 43.12, and χ 2=15-44; P 〈 0.01 for all comparisons ）. Conclusions Lamaze method for pain-relieving delivery can shorten duration of childbirth process, relieve level of labor pain, and strongly facilitate natural labor in primiparas. It is a valuable delivery method for clinical recommendation and application.