自由体位联合分娩减痛法在自然分娩初产妇中的临床应用

Clinical application of free postural delivery combined with childbirth pain reduction method in natural labor primipara

目的探析自由体位联合分娩减痛法在自然分娩初产妇中的临床应用价值及安全性。方法回顾性分析2016年11月至2017年12月在温州市人民医院产科自然分娩的200例初产妇的临床资料。根据分娩方式不同分为观察组(自由体位联合分娩减痛法)和对照组(分娩减痛法),每组100例,比较两组产妇的妊娠结局。结果观察组产妇的总产程、各产程时间(第一、第二、第三产程)、产后出血量和疼痛评分均显著低于对照组(t值分别为11.39、14.78、26.78、15.20、5.510、15.03,均P<0.05),且中转剖宫产率、会阴侧切、会阴Ⅱ度撕裂发生率均显著低于对照组(χ~2值分别为4.348、5.380、4.348,均P<0.05)。观察组新生儿Apgar评分显著高于对照组(t=6.500,P<0.05),总不良反应发生率显著低于对照组(χ~2=5.207,P<0.05)。结论自由体位分娩结合分娩减痛法在自然分娩初产妇中具有突出的临床价值,安全性良好,对产妇及新生儿的身体健康有利,值得推广。

Objective To analyze the clinical application value and safety of free postural delivery combined with childbirth pain reduction method in natural labor primipara. Methods Clinical data of 200 primipara having spontaneous labor in People＇ s Hospital of Wenzhou City from November 2016 to December 2017 was retrospectively analyzed. They were divided into observation group （free postural delivery combined with childbirth pain reduction method） and control group （childbirth pain reduction method） according to different delivery methods with 100 cases in each group. Pregnant outcomes in two groups were compared. Results Total labor time, time of each stage （first, second and third stage of labor）, maternal postpartum blood loss and pain scores in the observation group were significantly lower than those in the control group （t value was 11.39, 14.78, 26.78, 15.20, 5.510 and 15.03, respectively, all P^0.05）, and the rates of transfering to cesarean delivery, episiotoray and II degree laceration perineum in the observation group were significantly lower than those in the control group （χ2 value was 4.348, 5.380 and 4.348, respectively, all P〈0.05）. Apgar score of neonates in the observation group was significantly higher than that in the control group （t = 6.500, P〈0.05）, and incidence of total adverse reactions in the observation group was significantly lower than that in the control group （χ2 =5.207, P〈0.05）. Conclusion Free postural delivery combined with childbirth pain reduction method has prominent clinical value and safety in natural childbirth primipara, which is beneficial to puerpera and newborns, so it is worth promoting.