水中分娩及心理支持的现代医学模式在焦虑初产妇中的临床应用

The clinical observation of anxiety situation of primiparae with water birth

目的探讨水中分娩及心理支持的现代医学模式在焦虑初产妇中的临床效果,并与传统分娩方式进行比较。方法选择2011年6月至2012年9月十堰市妇幼保健院82例水中分娩(观察组)及86例传统分娩(对照组)焦虑初产妇的临床资料,比较两组第一产程末去甲肾上腺素(NE)、肾上腺素(E)水平及产妇妊娠结局。结果观察组第一产程末NE(20.37±5.18)nmol/L及E(0.38±0.22)nmol/L低于对照组NE(27.08±5.56)nmol/L及E(0.62±0.36)nmol/L,差异有统计学意义(P<0.05)。观察组活跃期时间及第二产程时间明显短于对照组,差异有统计学意义(P<0.05),观察组产后出血量少于对照组。观察组疼痛感明显轻于对照组,会阴侧切率明显低于对照组(P<0.05)。水中分娩组新生儿情况优于对照组,但差异无统计学意义(P>0.05),两组产褥感染差异亦无统计学意义。结论对于焦虑的初产妇,水中分娩及心理支持的现代医学模式能降低产妇儿茶酚胺类激素水平,有效地缓解焦虑情绪;同时能减轻产妇疼痛感,缩短产程,减少产后出血量,不会对新生儿安全造成危害。

Objective To explore modem medical model of water delivery and psychological support in the clinical effects of anxiety primipara comparison with traditional hildbirth. Methods In 2011 June to 2012 September in Shiyan Maternal and 82 cases of water delivery（ the observation group）and 86 cases of traditional childbirth（ control group） compared be- tween the two groups at the end of the first stageof norepinephrine （ NE）, epinephrine （ E the outcome of pregnancy and parturient. Results The fist stage NE at the end of the observation group（20. 37 ± 5.18 ） nmol/L and E （0. 38 ± 0. 22 ） nmol/L was lower than the control group NE （27.08 ± 5.56） nmol/L and E （0. 62 ± 0. 36） nmol/L, the difference was statistically significant （ P 〈 0. 05 ）. The observation group active period of time and the second stage of labor time was shorter than the control group, the difference was statistically significant （ P 〈 0.05 ）. The observation group pain signifi- cantly lighter than the control group, the water delivery group episiotomy rate was significantly lower than the control group （ P 〈 0. 05 ）. Water birth neonates was significantly better than the control group, but the difference was not statis- tically significant （P 〉 0. 05 ）, two groups of puerperal infection is also no significant difference. Conclusion Modem medical model of early maternal anxiety, water delivery and psychological support can reduce the level of maternal cate- cholamine hormones, relieve anxiety ; can reduce maternal pain, shorten labor, reduce the rate of episiotomy and post- partum hemorrhage.