时距式松弛技术对初产妇分娩过程的影响研究

Effect of spaced relaxation technique on delivery process of primiparas

目的探讨时距式松弛技术对初产妇分娩过程的影响。方法将自然临产健康初产妇根据是否有意愿行硬膜外自控镇痛或非药物镇痛分为硬膜外自控镇痛组(PCEA组,n=294)和时距式松弛训练组(n=235)。宫口开2 cm后,时距式松弛训练组予时距式松弛训练镇痛,PCEA组予椎管内药物镇痛,观察两组分娩过程、分娩结局及分娩体验。结果两组产妇干预前、后单次阵痛痛觉时距、单次阵痛心率增快时距组间和组内比较,差异有统计学意义(P<0.05,P<0.01);时距式松弛训练组干预后疼痛视觉评分、分娩舒适度评分较PCEA组高,干预后产程时长较短,差异有统计学意义(均P<0.01);时距式松弛训练组产妇相较于PCEA组缩宫素使用率及阴道器械助产率低,差异有统计学意义(P<0.05,P<0.01)。结论时距式松弛技术可帮助产妇减轻分娩疼痛,缩短产程,减少产科干预,增加分娩舒适感。

Objective To investigate the effect of spaced relaxation technique on delivery process of primiparas.Methods Healthy primiparas planning a natural labor were divided into a spaced relaxation training group if they intended to receive non-drug analgesia(n=235),and a PCEA group(n=294)if they intended to receive patient-controlled epidural analgesia(PCEA).Since 2 cm dilation of the uterine orifice was achieved,the former group was given spaced relaxation training,while the latter group received analgesics by the intraspinal routes.The delivery process,delivery outcome and delivery experience among the 2 groups were observed.Results There were significant before-after changes in the time interval of a single birth pang and time interval of heart rate increase during a single birth pang in each group;there were also significant changes in the above-mentioned 2 outcome measures after intervention between the 2 groups(P<0.05,P<0.01).The spaced relaxation training group saw significantly higher VAS pain scores,labor comfort scores,and shorter duration of labor after intervention,than the PCEA group(P<0.01 for all);the former group also had lower proportions of oxytocin administration and assisted vaginal birth than the latter group(P<0.05,P<0.01).Conclusion Spaced relaxation technique helps lessen birthing pain,shorten the duration of labor,reduce obstetric intervention,and increase the comfort level of child birthing women.