侧卧位与截石位在足月初产妇第二产程护理中的应用比较

Comparison of the application of lateral position and lithotomy position in the second stage of labor nursing of full-term primiparas

目的比较侧卧位与截石位在足月初产妇第二产程护理中的应用效果,指导足月初产妇第二产程护理干预。方法选择2018年4月—2020年4月南京医科大学第一附属医院120例足月初产妇作为研究对象,按照随机数字表法将其分为观察组(60例)与对照组(60例)。观察组在第二产程时采用侧卧位,对照组在第二产程时采用截石位。比较两组产妇第二产程时间、阴道分娩率、分娩后2、4、8 h会阴疼痛程度[视觉模拟评分(VAS)评估]、会阴损伤及会阴侧切发生率。结果观察组第二产程短于对照组,阴道助产率低于对照组,差异均有统计学意义(均P<0.05);两组产后8 h VAS低于产后2、4 h,产后4 h VAS低于产后2 h;观察组产后各时点VAS低于对照组,差异均有统计学意义(均P<0.05);观察组会阴损伤、会阴侧切发生率低于对照组,差异均有统计学意义(均P<0.05)。结论足月初产妇第二产程护理中使用侧卧位利于缩短第二产程,有效减少阴道助产,且利于减轻产妇产后会阴疼痛程度,减少会阴损伤与会阴侧切的发生。

Objective To compare the application effect of lateral position and lithotomy position in the second stage of labor nursing for full-term primiparas,to guide the nursing intervention for the second stage of labor for full-term primiparas.Methods From April 2018 to April 2020,120 full-term primiparas in the First Affiliated Hospital of Nanjing Medical University were selected as the research objects.They were divided into observation group(60 cases)and control group(60 cases)by random number table method.Observation group was used the lateral position during the second stage of labor,and control group was used the lithotomy position during the second stage of labor.The duration of the second stage of labor,the vaginal delivery rate,the perineal pain degree(visual analogue scale[VAS]assessment)at 2,4,8 h after delivery,and the incidence of perineal injury and perineal lateral resection between two groups were compared.Results The second stage of labor in observation group was shorter than that in the control group,and the vaginal delivery rate was lower than that in control group,and the differences were significant statistically(all P<0.05).VAS score at 8 h after delivery was lower than that at 2,4 h after delivery,VAS score at 4 h after delivery was lower than that at 2 h after delivery;VAS scores of observation group at each time point were lower than those of the control group,and the differences were significant statistically(all P<0.05).The incidence of perineal injury and perineal lateral resection in observation group were lower than those in control group,and the differences were significant statistically(all P<0.05).Conclusion The use of lateral position in the second stage of labor for full-term primiparas are beneficial to shorten the second stage of labor,effectively reduce vaginal delivery,and reduce the degree of perineal pain,perineal injury and perineal lateral resection.