镇痛分娩联合自由体位分娩对初产妇分娩结局的影响

Effect of analgesia delivery combined with free posture delivery nursing on delivery outcome of primiparas

目的分析镇痛分娩联合自由体位分娩用于初产妇阴道分娩的价值。方法选取2016年3月~2018年7月我院符合标准初产妇阴道分娩268例患者,根据随机数字表法分为对照组与研究组,每组各134例。对照组接受镇痛分娩,研究组在对照组基础上联合自由体位分娩,并在分娩期实施合理护理干预。比较两组产程、疼痛程度及分娩结局。结果研究组分娩期疼痛等级为0~2级64例,对照组39例,研究组多于对照组,差异有统计学意义(Z=3.612,P<0.001);研究组第一至第三产程及总产程分别为(6.12±1.51)h、(1.01±0.31)h、(7.88±1.59)min、(7.69±1.62)h,短于对照组的(9.01±1.79)h、(1.79±0.29)h、(12.61±2.89)min、(11.01±1.78)h,差异均有统计学意义(t=21.758、21.270、16.600、15.968,P<0.001);研究组产后出血、中转剖宫产、新生儿窒息发生率分别为0.75%、1.49%、0.75%,低于对照组的5.97%、8.96%、5.97%,差异均有统计学意义(χ2=4.139、7.537、4.139,P<0.05)。结论镇痛分娩联合自由体位分娩于初产妇阴道分娩效果优于单纯镇痛分娩,产妇产程缩短,分娩疼痛缓解,产后出血、新生儿窒息等不良结局发生减少,分娩安全性增加。

Objective To analyze the value of analgesia delivery combined with free posture delivery nursing in primiparas with vaginal delivery.Methods A total of 268 primiparas with vaginal delivery who met the standard in our hospital from March 2016 to July 2018 were selected,and they were divided into control group and research group according to the random number table method,134 cases in each group.The control group received analgesia delivery,while research group was given free posture delivery based on control group,and was given reasonable nursing intervention during delivery.The time of each stage of labor,pain degree and delivery outcome were compared between the two groups.Results There were 64 cases of pain degree with 0-2 during delivery in research group and 39 cases in control group,and research group was more than control group,and the difference was statistically significant(Z=3.612,P<0.001).The time of first to third stage of labor and total stages of labor in research group([6.12±1.51]h,[1.01±0.31]h,[7.88±1.59]min,[7.69±1.62]h)were shorter than those in control group([9.01±1.79]h,[1.79±0.29]h,[12.61±2.89]min,[11.01±1.78]h),and the differences were statistically significant(t=21.758,21.270,16.600,15.968,P<0.001).The incidence of postpartum hemorrhage rate,conversion to cesarean section and neonatal asphyxia in research group(0.75%,1.49%,0.75%)were lower than those in control group(5.97%,8.96%,5.97%),and the differences were statistically significant(χ2=4.139,7.537,4.139,P<0.05).Conclusion Analgesia delivery combined with free posture delivery for primiparas with vaginal delivery is better than simple analgesia delivery,it can shorten the time of stages of labor,relieve delivery pain,reduce the incidence of postpartum hemorrhage and neonatal asphyxia,and increase the safety of delivery.