体位指导对孕妇生产过程及舒适度的影响

The effect of posture guidance on the process and comfort among pregnant women

目的观察体位指导对孕妇生产过程及舒适度的影响。方法选择192例有阴道试产条件的孕妇为研究对象,采取随机数字表法分为观察组和对照组各96例,待宫颈口开到〉3 cm时,对照组采用常规平卧截石位姿势分娩,观察组采用坐位姿势分娩。结果 1产程与产后2 h出血量：观察组第一产程、第二产程、第三产程时间均明显短于对照组,产后2 h出血明显低于对照组,差异有统计学意义（t=5.910~8.079,P〈0.05）。2分娩方式与分娩结局：观察组产妇阴道自然分娩率（96.87%）高于对照组（86.46%）,会阴侧切率（15.63%）低于对照组（35.42%）,新生儿APORG评分明显高于对照组,新生儿窒息率（1.04%）明显低于对照组（9.38%）（t=5.228~9.8929,P〈0.05）,差异均有统计学意义。3产痛程度：观察组视觉模拟量表（VAS）、言语反应量表（VRS）、现实疼痛强度量表（PPI）评分均明显低于对照组,差异有统计学意义（t=4.155~8.518,P〈0.05）。4舒适度与满意度：观察组产妇生产舒适度、产后舒适度、满意度均明显高于对照组,差异有统计学意义（t=6.385~6.823,P〈0.05）。结论体位指导有助于缩短产程时间,提高阴道自然分娩率,缓解产后疼痛,减少会阴损伤与婴儿窒息率,提高产妇舒适度及满意度。

Objective To observe the effect of posture guidance on the process and comfort among pregnant women. Methods A total of 192 cases of pregnant women with vaginal delivery conditions were selected as the research object,and they were divided into observation group and control group by random number table,each group were 96 cases. When the cervical mouth open more than 3cm,the control group was treated with routine supine lithotomy position delivery while the observation group with delivery in a sitting posture. Results 1 the course of childbirth and 2 Hour postpartum hemorrhage： the observation group had shorter times in the first stage labor,the second stage labor and the third stage labor than that of control group,and also had lower postpartum hemorrhage than control group（ t = 5. 910- 8. 079,P 0. 05）; 2 the mode of delivery and birth outcomes： compared with control group,observation group had higher maternal vaginal delivery rate（ 96. 87% vs 86. 46%）,lower perineotomy rate（ 15. 63% vs 35. 42%）. And APORG score of observation group was significantly higher than that of control group,the incidence of neonatal asphyxia（ 1. 04%） was significantly lower than that of control group（ t = 5. 228- 9. 8929,P 0. 05）; 3 the degree of labor pain： the observation group had lower scores in visual analogue scale（ VAS）,verbal response scale（ VRS） and the real pain intensity scale（ PPI） than control group（ t = 4. 155- 8. 518,P 0. 05）; 4 the comfort and satisfaction： maternal postpartum production comfort,comfort and satisfaction of observation group were significantly higher than that of control group（ t = 6. 385- 6. 823,P 0. 05）. Conclusion The position guidance can shorten the labor time,improve the vaginal natural delivery rate,relieve the postpartum pain,reduce the rate of perineal injury and infant asphyxia,and can improve the comfort degree and satisfaction degree of the maternal.