自由体位分娩加分娩减痛法在初产顺产妇中的临床应用效果

Clinical Effect of Comprehensive Application of Free Position Childbirth and Delivery Analgesia Method in Primiparous and Eutocia Puerperae

目的:研究和探讨自由体位分娩法和分娩减痛法结合起来在初产顺产妇中的临床应用效果。方法:选取2013年1月至2013年12月已被收治的符合标准的初产顺产妇女360例为研究对象,将其随机分成A1组(自由体位分娩法组)、A2组(分娩减痛法组)和A1+A2组(两种方法结合组),每组120例。观察和比较三组产妇阴道分娩产程时间、疼痛等级评分、出血量、剖宫产率、新生儿Apgar评分情况和产后不良情况发生率。结果:①A1+A2组的分娩产程时间低于A1组及A2组,疼痛等级评分优于A1组和A2组(P均<0.05);②A1+A2组的分娩过程中的出血量和剖宫产率均低于A1组及A2组(P<0.05);③A1+A2组新生儿Apgar评分情况比A1组及A2组好(P<0.05);④A1+A2组产后不良情况的发生率也低(P<0.05)。然而以上观察指标A1组与A2组之间的差异均无统计学意义(P>0.05)。结论:在临床实践过程中对初产顺产产妇实施自由体位分娩结合分娩减痛法可以显著地改善产妇分娩过程中的不良情况,对新生儿的影响也是积极的。两种方法的综合应用更具有良好的临床效果。

Objective： To study and explore clinical effect of combining application of flee position childbirth method and childbirth pain reduction method in first-timer and eutocia maternal. Methods： Selected first-timer natural labor women 360 cases treated in between January 2013 and January 2014 as the research object, randomly divided into groups of A1 group （free position childbirth group）, A2 （childbirth pain reduction group） and A1 ＋ A2 group （combining two methods group）, 120 cases in each group. Observed and compared three groups in term of maternal vaginal delivery labor time, pain rating score, blood loss, cesarean section rate and neonatal Apgar score and the incidence of postpartum adverse situation. Results： （1） childbirth labor time ofA1 ＋ A2 group was under A1 and A2 group, but pain grade was better than A1 and A2 group （P〈0.05）; （2） blood loss and the rate of cesarean section in the process of childbirth of A1 ＋ A2 group were less than A1 and A2 group （P〈0.05）; （3） neonatal Apgar score of A1 ＋ A2 group was better than A1 and A2 group （P〈0.05）; （4） A1 ＋ A2 group with a lower rate of postpartum adverse situation （P〈0.05）. However, as to the above observation indexes the difference between A1 and A2 group had no statistical significance （P〉0.05）. Conclusion： In the process of clinical practice for the first-timer eutocia puerperae, the comprehensive application of liberalized position labor and labor pain relief method can significantly improve maternal adverse conditions in the process of childbirth, was also a positive effect on neonatal. The combined application of two methods had a good clinical effect.