第二产程分阶段体位管理对分娩影响的临床研究

Clinical study on effects of phased position control in the second stage of labor on delivery

目的探讨第二产程分阶段体位管理对第二产程和分娩的影响。方法 220例初产妇随机分为观察组和对照组,对照组第二产程按常规仰卧位或半卧截石位屏气用力和分娩,观察组在第二产程采取分阶段体位管理,比较两组剖宫产率、第二产程时间、自主用力时间、生殖道损伤情况及产妇满意度。结果观察组剖宫产率、第二产程时间、自主用力时间、会阴侧切、Ⅰ度会阴裂伤、宫颈裂伤均明显低于对照组,产妇满意度量表总分明显优于对照组(P<0.05)。结论第二产程分阶段体位管理可缩短第二产程,提高顺产率,减少产妇的生殖道损伤,值得临床推广。

Objoctive To study the effects of phased position control in the second stage of labor on the stage and delivery. Mothaods 220 primiparas were divided into observation group and control group randomly. The primiparas in the control group chose the normal position like supine position or lithotomy position to exert and deliver in the second stage of labor. The primiparas in the observation group chose phased position control in the second stage of labor. Comparison was made in the rate of cesarean delivery, time of the second stage of labor, self exerting time, situation of genital tract injuries, and primiparas＂ satisfaction between the two groups. Rosults The incidence rate of cesarean, lateral perineal incision, the first degree perineal laceration, and cervical laceration and the time of the second stage of labor, the self exerting time in the observation group were obviously lower and shorter than those in the control group （P 〈 0.05）. Conclusion The phased position control in the second stage of labor can shorten the time of the second stage of labor, increase the rate of eutocia, and decrease vulneratio genitalis, which is worthwhile to be clinically promoted.