自由体位分娩配合会阴无保护接生技术对分娩结局的影响研究

Clinical study on the effect of free posture deliverycombined with perineal unprotected delivering technology on delivery outcome

目的探讨自由体位分娩配合会阴无保护接生技术对分娩结局的影响。方法选取2017年4月~2018年12月我院收治的120例产妇,依据不同的就诊顺序将其分为对照组(n=60)与试验组(n=60),对照组施以常规的助产方式,试验组施以自由体位分娩配合会阴无保护接生技术,观察两组产妇的会阴裂伤程度情况,第一产程、第二产程、第三产程、总产程时间,分娩方式情况,会阴疼痛情况,产后出血情况,新生儿Apgar评分情况、新生儿窒息率情况,并发症发生情况。结果试验组的产程时间为(312.62±114.59)min,明显短于对照组的(403.32±125.27)min,二者比较,差异有统计学意义(t=4.138,P=0.000),会阴裂伤程度明显较轻,二组比较差异有统计学意义(χ^2=9.412、3.927、5.217、4.904与5.175,P=0.002、0.048、0.022、0.027与0.023),会阴疼痛分级明显较低,二组比较差异有统计学意义(χ^2=28.824,P=0.000),试验组的新生儿Apgar评分为(8.01±0.89)分,明显高于对照组的(6.97±1.08)分,差异有统计学意义(t=5.756,P=0.000),自然分娩率为86.67%,明显高于对照组的21.67%,二者比较差异有统计学意义(χ^2=51.055,P=0.000),产后出血发生率、新生儿窒息率与并发症发生率分别为5.00%、1.67%与3.33%,明显低于对照组的31.67%、15.00%与16.67%,两组比较差异具有统计学意义(χ^2=14.249、6.982与5.926,P=0.000、0.008与0.000)。结论自由体位分娩配合会阴无保护接生技术对分娩结局具有积极影响,不仅能够缩短产程时间,减轻会阴裂伤程度与会阴疼痛分级,同时降低会阴侧切发生率、产后出血发生率、宫颈裂伤发生率、新生儿窒息率与并发症发生率,提升新生儿的Apgar评分。

Objective To explore the effect of free posture delivery and perineal unprotected delivering technology on delivery outcome.Methods 120 parturient women who were admitted and treated in our hospital from April 2017 to December 2018 were selected.According to different treatment order,they were divided into the control group(n=60)and the experimental group(n=60).The control group was given conventional midwifery while the experimental group was given free position delivery combined with perineal unprotected delivering technology.The degree of perineal laceration,first stage of labor,second stage of labor,third stage of labor,total labor time,delivery mode,perineal pain,postpartum hemorrhage,neonatal Apgar score,asphyxia rate and complications were observed.Results The total labor time of the experimental group was(312.62±114.59)min,which was significantly shorter than that of the control group(403.32±125.27)min,and the difference was significant(t=4.138,P=0.000).The degree of perineal lacerations in the experimental group was significantly less severe,and there were significant differences between the two groups(χ^2=9.412,3.927,5.217,4.904,5.175,P=0.002,0.048,0.022,0.027,0.023).The grading of perineal pain was significantly lower in the experimental group,and the difference between the two groups was significant(χ^2=28.824,P=0.000).The Apgar score of neonates in the experimental group was(8.01±0.89),which was significantly higher than that of the control group(6.97±1.08).The difference was significant(t=5.756,P=0.000).The natural delivery rate of the experimental group was 86.67%,significantly higher than that of the control group(21.67%),There were significant differences between two groups(χ^2=51.055,P=0.000).The incidence of postpartum hemorrhage,neonatal asphyxia and complications in the experimental group were 5.00%m 1.67%and 3.33%respectivelym which were significantly lower than 31.67%m 15.00%and 16.67%in the control group.The differences between the two groups were statistically significant(χ^2=14.249,6.982 and 5.926,P=0.000,0.008 and 0.000).Conclusion Free posture delivery combined with perineal unprotected delivering technology has a positive effect on delivery outcomes.It can not only shorten the labor time,reduce the degree of perineal laceration and perineal pain grading,but also reduce the incidence of perineal cut,the incidence of postpartum hemorrhage,the incidence of cervical laceration,neonatal asphyxia and complication rate,and improve the neonatal Apgar score.