心理干预在分娩中的作用

Effect of psychological intervention on labor

目的探讨心理干预对分娩所产生的影响。方法孕妇于孕37周进行焦虑自评量表（SAS）、抑郁自评量表（SDS）检测，sAS和／或SDS〉40分的孕妇200例，进行心理干预（焦虑抑郁干预组）；同时将SAS和SDS≤40分的孕妇400例，随机分成正常组和进行心理干预的正常干预组。比较三组产妇产程时间、手术产率、胎儿窘迫及产后出血发生率。结果焦虑、抑郁干预组第一、二产程时间（7．67±2．24hvs10．02±3．56h，0．91±0．21hvs1．12±0．26h，t=7．90，8．89，P〈0．05）、手术产率（24．5％vs39．0％,X^2=9．70，P〈0．05）、胎儿窘迫（11．5％vs20．5％,X^2=6．03，P〈0．05）及产后出血发生率（0．5％vs4．0％，X^2=4．09，P〈0．05）明显低于正常组，差异有统计学意义；正常干预组第一、二产程时间（7．20±3．02hvs10：02±3．56h，0．87±0．21hvs1．12±0．26h．t=8．54，10．58，P〈0．05）、手术产率（17．5％vs39．0％，X^2=22．80，P〈0．05）、胎儿窘迫（9．5％vs20．5％,x^2=9．49。P〈0．05）及产后出血发生率（0．5％VS4．0％，X^2=4．09，P〈0．05）明显低于正常组，差异具有统计学意义。结论有效的心理干预可以缩短产程，促进自然分娩，减少母婴并发症。

Objective To discuss the influence of psychological intervention on labor. Methods Pregnant women at 37 gestational week were measured with Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS）. According to the scores, 200 pregnant women （SAS/SDS 〉 40） accepted psychological intervention （anxiety-depression intervention group）, while another 400 pregnant women （SAS and SDS ~〈40） were randomly divided into two groups： normal group and normal psychological intervention group. The duration of labor, rate of cesarean section, incidence of fetal distress and postpartum hemorrhage were compared among three groups. Results Compared with normal group, the first and second stage of labor（7.67 ±2.24h vs 10.02±3.56h,0.91±0.21h vs 1.12 ±0.26h, t value was 7.90 and 8.89, respectively, both P 〈 0.05 ）, rate of cesarean section （24.5 % vs 39.0%, X^2 = 9.70, P 〈 0.05 ）, incidence of fetal distress （ 11.5 % vs 20.5 % ,X^2 = 6.03, P 〈 0.05 ） and incidence of postpartum hemorrhage （ 0.5 % vs 4.0%, X^2 = 4.09, P 〈 0.05 ） were decreased significantly in anxiety-depression intervention group, and the differences were statistically significant. Compared with normal group, the first and second stage of labor（7.20 ± 3.02h vs 10.02 ± 3.56h,0.87 ± 0.21h vs 1.12 ± 0.26h, t value was 8.54 and 10.58, respectively, both P 〈 0.05 ）, rate of cesarean section （ 17.5 % vs 39.0% , X2 = 22.80, P 〈 0.05 ）, incidence of fetal distress （9.5% vs 20.5% ,X2 = 9.49, P 〈 0.05 ） and incidence of postpartum hemorrhage （0.5% vs 4.0%, X2 = 4.09, P 〈 0.05 ） were significantly decreased in normal intervention group, and the differences were statistically significant. Conclusion Effective psychological intervention can shorten stage of labor, promote natural childbirth and reduce maternal complications.