全程陪护对产后出血及剖宫产率的影响研究

Effect of full escort delivery on postpartum hemorrhage and cesarean section rate

目的探讨助产士全程陪护对降低产妇分娩出血率和提高顺产率的效果。方法选择2012年7月至2013年7月期间收治的480例产妇为研究对象,并将其随机分为两组。对照组280例给予常规陪护;研究组200例给予助产士全程陪护,实施一对一人性化陪护。比较两组产妇的分娩方式、产程、分娩出血量及满意度。结果研究组的平均分娩时间为(7.31±0.98)h,明显少于对照组的(10.86±2.23)h(t=16.513,P<0.05);研究组的剖宫产率为3.00%,明显低于对照组的16.79%(x^2=22.573,P<0.05)。研究组产妇的SAS评分为(46.39±2.65)分,明显少于对照组的(57.36±6.71)分(t=13.402,P<0.05);研究组的产后出血率为3.50%,明显低于对照组的8.93%(x^2=5.526,P<0.05);但两组新生儿Apgar评分比较无显著性差异(P>0.05)。研究组产妇的回访满意度为94.00%,明显高于对照组的76.43%,两组比较有显著性差异(x^2=26.468,P<0.05)。结论助产士全程陪护能够有效的缩短分娩时间,提高产妇的分娩质量,稳定产妇的情绪,降低产妇分娩出血率,值得临床推广。

Objective To investigate the effect of full escort delivery on the reduction of maternal delivery hemorrhage and improvement of vaginal delivery rate.Methods A total of 480 pregnant women admitted during the period of July 2012 to July 2013 were randomly divided into two groups, 280 cases in control group accepting routine nursing and 200 cases in study group treated with midwife’ s full escort delivery nursing.The mode of delivery, maternal labor, postpartum bleeding and satisfaction degree of two groups were compared.Results The average delivery time of the study group was 7.31 ±0.98h, which was significantly shorter than that in the control group （10.86 ± 2.23h） （t=16.513,P〈0.05）.The cesarean section rate of the study group was 3.00%, and it was significantly lower than that in the control group （16.79%） （χ^2 =22.573,P〈0.05）.The SAS score of the study group was significantly less than that in the control group （46.39 ±2.65 vs 57.36 ±6.71） （t=13.402,P〈0.05）.The postpartum hemorrhage rate of the study group was 3.50%, and it was lower than 8.93%in the control group （χ^2 =5.526,P〈0.05）, but there was no significant difference between two groups in neonatal Apgar score （P〉0.05）.Visit satisfactory degree of the study group was 94.00%, which was remarkably higher than that in the control group （76.43%）, and the difference was significant （χ^2 =26.468,P〈0.05）.Conclusion The midwife’s full escort delivery nursing can effectively shorten delivery time, improve delivery quality and maternal mood stability, and reduce hemorrhage rate, so that it is worthy of clinical promotion.