导乐仪联合导乐陪伴对高龄初产妇分娩疼痛和分娩质量的影响

Effect of Doula instrument combined with Doula accompanying on labor pain and quality of elderly primipara

目的探讨导乐仪联合导乐陪伴对高龄初产妇分娩疼痛和分娩质量的影响。方法选取150例自然分娩的高龄初产妇作为研究对象,采用计算机随机分组法分为常规组和导乐组,各75例。常规组采用传统待产分娩模式,宫口全开后上产床分娩,导乐组采用分娩镇痛导乐仪联合一对一全程导乐陪伴,观察2组产妇视觉模拟评分法(VAS)评分、产程时间、分娩方式、产后2 h出血量和产后并发症发生情况。结果2组第三产程时间比较,差异无统计学意义(P>0.05),导乐组分娩疼痛VAS评分(4.23±1.06)分低于常规组(7.87±1.45)分,第一产程时间(383.51±108.31)min、第二产程时间(45.73±8.30)min、总产程时间(437.07±112.56)min分别短于常规组(472.08±125.72)、(61.30±10.51)、(541.70±138.07)min,产后2 h出血量(109.54±28.30)mL少于常规组(132.34±31.25)mL,差异均有统计学意义(P<0.05);导乐组自然分娩率93.33%高于常规组82.67%,剖宫产率6.67%低于常规组17.33%,差异有统计学意义(P<0.05)。导乐组总并发症率2.67%低于常规组12.00%,差异有统计学意义(P<0.05)。结论导乐仪联合导乐陪伴能显著减轻高龄初产妇分娩疼痛,缩短产程时间,促进自然分娩,减少新生儿窒息、产后感染和尿潴留等并发症的发生。

Objective To explore the effect of Doula instrument combined with Doula accompanying on delivery pain and quality of elderly primiparas.Methods A total of 150 elderly natural delivery primiparas were divided into routine group(n=75)and Doula group(n=75)by computer randomized method.The routine group was given the traditional mode of labor,and the delivery was performed after the opening of the uterine orifice.The Doula group was given the labor analgesia by Doula instrument combined with one-to-one whole-course Doula accompanying.The Visual Analogue Scale(VAS)score,the time of labor,the mode of delivery,the amount of bleeding at 2 hours after delivery and the occurrence of postpartum complications were observed.Results There was no significant difference between the two groups in the third stage of labor(P>0.05).The VAS score of labor pain in the Doula group were(4.23±1.06)points,which was lower than(7.87±1.45)points in the routine group,the first stage of labor,the second stage of labor and whole-course labor time were(383.51±108.31)min,(45.73±8.30)min,(437.07±112.56)min,respectively,in the Doula group,which were shorter than(472.08±125.72),(61.30±10.51),(541.70±138.07)min,respectively,in the routine group.The amount of postpartum hemorrhage was(109.54±28.30)mL,which was lower than(132.34±31.25)mL in the routine group(P<0.05).The natural delivery rate of Doula group was higher than that of the conventional group(93.33%vs.82.67%),and the cesarean section rate was lower(6.67%vs.17.33%),the total complication rate of the Doula group was significantly lower than that of the conventional group(2.67%vs.12.00%),which all showed significant differences(P<0.05).Conclusion Doula instrument combined with Doula accompanying can significantly reduce the pain of delivery,shorten the labor time,promote natural childbirth,reduce complication rates such as neonatal asphyxia,postpartum infection and urinary retention.