分阶段体位管理联合自主屏气用力对初产妇第二产程和分娩结局的影响

Influence of phased body position management combined with independent breath holding for parturient at second stage of labor and delivery outcome of primipara

目的 探讨分阶段体位管理联合自主屏气用力对初产妇第二产程和分娩结局的影响。方法 选取2014年8月~2015年10月来我院妇产科正常分娩的初产妇170例,随机分为观察组及对照组各85例。观察并记录两组产妇的分娩方式、自主用力时间、第二产程时间、生殖道损伤情况及产妇的满意度。结果 观察组产妇阴道自然分娩率比对照组高,阴道助产及剖宫产率比对照组低,两组比较差异有统计学意义（P〈0.05）。观察组产妇的第二产程时间、自主用力时间明显短于对照组,产妇满意度高于对照组,两组比较差异有统计学意义（P〈0.05）。观察组的会阴侧切及宫颈裂伤率低于对照组,会阴裂伤Ⅱ度产妇少于对照组,两组比较差异有统计学意义（P〈0.05）。结论 对初产妇来说,分阶段体位管理联合自主屏气用力可以明显缩短第二产程,提高顺产率,减少产妇的生殖道损伤,值得推广应用。

Objective To explore the influence of phased body position management combined with independent breath holding for parturient at second stage of labor and delivery outcome of primipara. Methods 170 cases of normal delivery primipara from August 2014 to October 2015 in the obstetrics and gynecology department of our hospital were randomly divided into observation group and control group with 85 cases in each.The maternal mode of delivery,time of the second stage of labor,independent force time,reproductive tract injury and maternal satisfaction of the two groups were observed and recorded. Results Spontaneous vaginal delivery rate of observation group was higher than that of control group.Vaginal delivery and cesarean section of observation group were lo,ser than those of control group.The differences of the two groups were significant （P 〈 0.05）.Second stage of labor time and independent breath holding time of observation group were significantly shorter than those of the control group.Maternal satisfaction of observation group was higher than that of control group.The differences of the two groups were significant （P 〈 0.05）. Perineal cut and cervical laceration of the observation group were lower than those of control group,and the number of second degree perineal laceration patients of observation group was less than that of control group.The differences of the two groups were significant （P 〈 0.05）. Conclusion For primipara women,phased body position management combined with independent breath holding could significantly shorten the second stage of labor,increase the rate of vaginal delivery,and reduce maternal reproductive tract injury.It was worthy of popularization and application.