分娩球配合自由体位助产对初产妇产痛、分娩控制感及妊娠结局的影响

The Effect of Birth Ball Combined with Free Position Midwifery on Primipara Labour Pain,Delivery Control and Delivery Outcomes

目的:观察应用分娩球配合自由体位助产对初产妇分娩过程中产痛、分娩控制感以及妊娠结局的影响。方法:将2016年6月至2017年6月我院妇产科收治的100例初产妇纳入研究,采用随机数字表分为观察组和对照组,每组各50例。对照组采用传统卧位或半卧位方式进行待产,观察组采用分娩球配合自由体位方式。对比两组产妇的产痛、分娩控制感以及妊娠结局情况。结果:观察组与对照组相比较,产痛在0级和3级的差异无统计学意义,对照组1级产痛产妇有20例,占总人数的40%,观察组1级产痛产妇有37例,占总人数的74%,两组比较差异具有统计学意义(P<0.05);对照组2级产痛产妇有28例,占总人数的56%,观察组2级产痛产妇有13例,占总人数的26%,两组比较差异具有统计学意义(P<0.05)。对两组经阴道分娩的产妇应用LAS评分进行分娩控制感的比较,对照组有33例产妇经阴道分娩,LAS评分为(123.62±17.21),观察组有41例产妇经阴道分娩,LAS评分为(169.37±18.73),两组进行比较,差异具有统计学意义(P<0.05)。对两组产妇分娩方式进行比较,对照组经剖宫产17例,经阴道分娩33例,观察组经剖宫产8例,经阴道分娩42例,两组分娩方式差异具有统计学意义(P<0.05);对两组新生儿进行Apgar评分并比较,对照组评分(9.78±0.21),观察组评分(9.85±0.18),两组差异无统计学意义(P>0.05)。对两组经阴道分娩的产妇产后2 h出血量进行比较,对照组产妇出血量为(217.65±68.21)m L,观察组产妇出血量为(197.85±40.86)m L,两组差异无统计学意义(P>0.05);对两组经阴道分娩产妇产程时间进行比较,观察组产妇第一、第二产程时间均少于对照组,差异具有统计学意义(P<0.05),第三产程时间两组比较差异无统计学意义(P>0.05)。结论:在临床应用中,初产妇采取分娩球配合自由体位助产可以降低分娩疼痛感、提高分娩控制感、缩短产程时间。

Objective： To observe the effect of birth ball combined with free position midwifery on the labour pain,delivery control and delivery outcomes of primipara. Methods： From June 2016 to June 2017,100 cases of primipara in our hospital were divided into the observation group and the control group,with 50 cases in each group. The control group used the traditional supine or semi supine position during the labour; the observation group used birth ball combined with free position midwifery. The labour pain,delivery control and delivery outcomes were compared between the two groups. Results： The difference of labour pain at level 0 and level 3 between two groups was not statistically significant. In the control group,20 cases had level 1 labour pain,accounting for 40% of the total number,in the observation group,37 cases had level 1 labour pain,accounting for 74% of the total number; there was statistically significant difference between the two groups（ P 〈 0. 05）. In the control group,28 cases had level 2 labour pain,accounting for 56% of the total number,in the observation group,13 cases had level 2 labour pain,accounting for 26% of the total number,there was statistically significant difference between the two groups（ P 〈 0. 05）. The delivery control of maternal vaginal delivery of the two groups was compared use LAS score; the control group had 33 cases of maternal vaginal delivery,LAS score was（ 123. 62 ± 17. 21）,the observation group had 41 cases of maternal vaginal delivery,LAS score was（ 169. 37 ± 18. 73）,the difference between the two groups was statistical significance（ P 〈 0. 05）.Comparing the mode of delivery of the two groups,the control group had 17 cases cesarean section,33 cases vaginal delivery,the observation group had 8 cases cesarean section,42 cases vaginal delivery,the difference between the mode of delivery of the two groups was statistically significant（ P 〈0. 05）. Comparing the newborn＇s Apgar score of the two groups,the control group was（ 9. 78 ± 0. 21）,the observation group was（ 9. 85 ± 0. 18）,the difference between the two groups was not statistically significant（ P 〉0. 05）. Comparing the maternal2 h postpartum hemorrhage of the two groups after vaginal delivery,the control group was（ 217. 65 ± 68. 21） m L,the observation group was（ 197. 85 ±40. 86） m L,the difference between the two groups was not statistically significant（ P 〉 0. 05）. Comparing the vaginal delivery birth process of the two groups,the time of the first and second stages of labour of the observation group were less than the control group,the difference was statistically significant（ P 〈 0. 05）,the difference between the time of the third stage of labour of the two groups was not statistically significant（ P 〉 0. 05）. Conclusion： In clinical practice,birth ball combined with free position midwifery can reduce the pain of delivery,improve delivery control and shorten the delivery time.