导乐陪伴与第二产程半卧抱膝位对分娩结局的影响

Effects of doula accompany and semireclining tuck position in the second stage of labor on deliver outcome

目的：探讨导乐陪伴与第二产程半卧抱膝位分娩对产时质量的影响。方法：选择2014年1月~2015年12月我院住院分娩的240例产妇并随机等分为观察组和对照组。观察组实施全程陪产，并在第二产程中采用床头抬高60°，呈半卧位双手抱膝位分娩；对照组实施传统服务模式并在第二产程采用膀胱截石位分娩。比较两组的分娩方式、第二产程时间、产后2 h 出血量、Apgar 评分。结果：观察组自然分娩率高于对照组，第二产程时间及产后2 h 出血量少于对照组，且新生儿 Apgar 评分优于对照组（P ＜0．05）；两组产妇剖宫产率、新生儿窒息率比较有统计学意义（P ＜0．05）。结论：第二产程半卧抱膝位配合导乐陪伴分娩能缩短第二产程，减少产后出血，降低剖宫产率及新生儿窒息率，是一种理想的分娩服务模式。

Objective：To explore the effects of doula accompany and semireclining tuck position delivery in the second stage of labor on delivery quality. Methods：Selected 240 puerperae delivering in our hospital during the period of January 2014 to December 2015,and randomly divided them into observation group and control group. Implemented birth support to the observation group and adopted the method of uplifting the bed for 60°and delivering in semireclin-ing tuck position in the second stage of labor;implemented traditional service mode and adopted bladder lithotomy position delivery method in the second stage of labor on the control group. Compared the delivery method,time of the second stage of labor,postpartum 2 - hours bleeding amount and Apgar scores. Results：Natural delivery rate of the observation group was higher than that of the control group,time of the second stage of labor and postpartum 2- hours bleeding amount were less than those of the control group and the Apgar scores of newborn were better than those of the control group（P 〈 0. 05）;the comparison of puerpera cesarean delivery rate and newborn asphyxia rate of the two groups was of statistical significance（P 〈 0. 05）. Conclusion：The combination of semireclining tuck position delivery and doula accompany can shorten the second stage of labor,reduce postpartum bleeding,lower cesarean delivery rate and newborn asphyxia rate,for which it is an ideal delivery service mode.