责任制助产护理模式联合产时体位管理对分娩结局的影响及意义

Influence and significance of responsibility midwifery model of care combined with intrapartum postural management for birth outcomes

目的探讨责任制助产护理模式联合产时体位管理对分娩结局的影响及意义。方法选取2010年7月-2012年6月的250例产妇作为常规组,采用传统轮班制助产护理模式,且不实施产时体位管理。选取2012年7月-2014年6月的250例产妇作为责任制组,采用责任制助产护理模式,并联合实施产时体位管理。观察两组的产程、产后出血及分娩结局。结果责任制组的第一、二产程时间显著短于常规组,差异有统计学意义（P〈0.01）;两组的第三产程时间比较,差异无统计学意义（P〉0.05）。责任制组的产后出血量为（168.2±34.7）ml,显著少于常规组的（263.2±56.2）ml,差异有统计学意义（P〈0.01）。责任制组的阴道分娩率显著高于常规组,差异有统计学意义（P〈0.01）。责任制组的新生儿娩出后5 min Apgar评分为（9.5±1.2）分,显著高于常规组的（8.2±1.1）分,差异有统计学意义（P〈0.01）。结论联合应用责任制助产护理模式与产时体位管理能够提高分娩安全性,缩短产程,减轻产妇痛苦,使母婴获得更好的结局。

Objective To explore the influence and significance of responsibility midwifery model of care combined with intrapartum postural management for birth outcomes. Methods 250 puerperas from July 2010 to June 2012 were selected as conventional group,which was given traditional midwifery model of care,and not given intrapartum postural management.250 puerperas from July 2012 to June 2014 were selected as responsibility group,which was given responsibility midwifery model of care combined with intrapartum postural management.Maternal labor,postpartum hemorrhage and birth outcomes in two groups was observed respectively. Results The labor through time of the first and second stage in the responsibility group was significantly shorter than that in the conventional group,with significant difference（P〈0.01）.The third stage time was not statistically significant between two groups（P〉0.05）.The postpartum blood loss of the responsibility group was（168.2±34.7） ml,which was lower than（263.2±56.2） ml of the conventional group,with significant difference（P〈0.01）.The rate of vaginal delivery of the responsibility group was significantly higher than that of conventional group,with significant difference（P〈0.01）.The Apgar score of neonates after 5 min in the responsibility group was（9.5±1.2） points,which was higher than（8.2±1.1） point in the conventional group,with significant difference（P〈0.01）. Conclusion The responsibility midwifery model of care combinated with postural management of intrapartum can improve labor safety,shorten borth process,reduce maternal pain,and mother and infant can get a better outcome.