导乐陪伴分娩对初产妇分娩结局及催产素使用率的影响

Influence of Doula delivery on delivery outcomes and oxytocin usage for primiparas

目的：探讨研究导乐陪伴分娩对初产妇分娩结局及催产素使用率的影响。方法随机选取本院妇产科于2013年9月~2015年9月收治的足月单胎头位初产妇110例，按照住院单双号平均分为观察组和对照组。对照组给予传统护理模式，观察组在传统护理基础上给予导乐陪伴分娩护理模式。对比两组分娩结局和催产素使用率。结果观察组产妇催产素使用率、各产程时间以及总产程时间均较对照组显著降低（ P〈0.05）；观察组产后出血量、阴道助产分娩、剖宫产、新生儿窒息发生率均较对照组显著降低，正常阴道分娩发生率较对照组显著升高，差异均具有统计学意义（ P〈0.05）；观察组产后2 h躯体化、强迫症状、人际关系、焦虑、抑郁、敌对、恐怖、偏执、精神病性等9个维度心理状态评分均较对照组显著减少（ P〈0.05）。结论对初产妇实施导乐陪伴分娩模式可以降低催产素使用率，改善分娩结局，值得在临床工作中推广应用。

Objective To discuss and study the influence of Doula delivery on delivery outcomes and oxytocin usage for primiparas. Methods A total of 110 cases of primiparas of full-term with single fetus and head position in the obstetrics and gynecology department of our hospital from September 2013 to September 2015 were randomly selected, who were divided into observation group and control group in accordance with the hospitalization dates being odd or even numbers. The control group were given the traditional nursing mode, while the observation group were given Doula deliv-ery nursing mode on basis of conventional nursing care. The delivery outcomes and oxytocin usage of the two groups were compared. Results The ultilization rate of oxytocin, the time of every labor and the total labor time of the observation group were significantly lower than that of the control group （P〈0. 05） . The postpartum bleeding volume, the rate of va-ginal delivery, cesarean section delivery and neonatal asphyxia of the observation group were significantly lower than that of the control group, and normal vaginal delivery rate was significantly higher than that of the control group, and the differ-ences were statistically significant （P〈0. 05） . For the observation group, the scores of psychological status in dimen-sions, including body, the symptoms of obsessive-compulsive disorder, interpersonal relationship, anxiety, depression, hostility, terror, paranoia, psychosis and so on 2 hours after delivery were significantly decreased compared with that of the control group （P〈0. 05） . Conclusions The implementation of Doula delivery mode on primiparas can reduce the oxyto-cin usage and improve delivery outcomes, which is worthy of popularization and application in clinical work.