导乐仪在瘢痕子宫再次妊娠足月阴道分娩的临床应用研究

Study on clinical application of Doula instrument on uterine scar pregnancy in term vaginal delivery

目的:探讨研究导乐仪在瘢痕子宫再次妊娠足月阴道分娩的临床应用效果。方法:选取92例瘢痕子宫再次妊娠足月有阴道分娩愿望的产妇按照意愿分为两组,其中不愿采用镇痛分娩的产妇共29例(记为自然分娩组),采用随机数字表法将愿意采用镇痛分娩的63例产妇分为药物镇痛组(32例)和导乐仪镇痛组(31例)。药物镇痛组给予硬膜外麻醉方式镇痛,导乐仪镇痛组给予导乐仪镇痛和陪伴分娩。观察对比三组产妇和围产儿状况。结果:三组VAS评分、总产程、产后2 h出血量、子宫破裂例数和阴道试产成功率比较,差异有显著统计学意义(P<0.05),而药物镇痛组和导乐仪镇痛组VAS评分、总产程、产后2 h出血量均较自然分娩组显著改善,差异有统计学意义(P<0.05),且导乐仪镇痛组阴道试产成功率较自然分娩组显著升高(P<0.05);三组围生儿各种不良事件比较,差异无统计学意义(P>0.05),而不良事件发生率差异显著(P<0.05),且药物镇痛组和导乐仪镇痛组均较自然分娩组显著改善,差异有统计学意义(P<0.05),导乐仪镇痛组较药物镇痛组显著改善,差异有统计学意义(P<0.05)。结论:采用导乐仪镇痛方式在瘢痕子宫再次妊娠足月阴道分娩中产妇结局和围产儿结局均较药物镇痛和自然分娩显著改善。

Objective To expolre and study the clinical application effect of Doula instrument on uterine scar pregnancy in term vaginal delivery.Method 92 cases of women with uterine scar pregnancy in term vaginal delivery were divided into two groups according to the intention of the pregnant women,and there were 29 cases who did not want to use the pain in childbirth（noted as natural delivery group）,then the 63 cases who wanted to use the pain in childbirth were devided into drug analgesia group（32 cases） and Doula delivery analgesia group（31 cases）.The drug analgesia group were given epidural anesthesia analgesia,and the Doula delivery analgesia groupwere given doula instrument and accompany delivery.The maternal and perinatal conditions of the three groups were observed an compared.Results The VAS scores,the total labor,postpartum 2-hour bleeding,uterine rupture cases and the success rates of vaginal delivery of the three groups were significantly different（ P〈0.05）,and the VAS scores,the total labor and postpartum 2-hour bleeding of the drug analgesia group and Doula delivery analgesia group were significantly better than those of the natural delivery group（ P〈0.05）,and the success rates of vaginal delivery of the Doula delivery analgesia group was significantly higher than that of the natural delivery group（ P〈0.05）.There were no significant differences between different kinds of the adverse events of the three groups（ P〉0.05）,but the incidence of adverse events was significantly different（ P〈0.05）,of which the drug analgesia group and Doula delivery analgesia group were significantly better than that of the natural delivery group（ P〈0.05）,of which the Doula delivery analgesia group was significantly better than that of the drug analgesia group（ P〈0.05）.Conclusion The implementation of Doula analgesia apparatus on uterine scar pregnancy in term vaginal delivery can significantly improve the outcomes of maternal and perinatal compared with the drug analgesia and natural labor.