第二产程不同时机运用腹压对分娩镇痛初产妇分娩结局的影响

Effect of using abdominal pressure at different times during the second stage of laboron the delivery outcome of primiparas with labor analgesia

目的探讨第二产程不同时机运用腹压对分娩镇痛初产妇分娩结局的影响。方法选取莆田市第一医院2019年1月~2019年12月收治的400例初产妇,按照随机数表法分为对照组(宫口开全即指导运用腹压)和观察组(宫口开全,胎先露坐骨棘下2.5~3 cm,产妇有充分屏气感时运用腹压),每组200例,比较两组一般情况,分娩后疲倦度及分娩结局。结果分娩早期两组患者的分娩疲倦度差异无统计学意义(P>0.05),中期及晚期观察组的分娩疲倦度低于对照组,差异有统计学意义(P<0.05);观察组患者分娩结局(产后出血、新生儿窒息、产后尿潴留、产后肠胀气)均优于对照组,差异有统计学意义(P<0.05)。结论对于分娩镇痛初产妇在胎先露坐骨棘下2.5~3 cm,有屏气感时运用腹压可缩短第二产程时间及使用腹压时间,产妇在分娩中晚期的疲倦度较低,不良反应少。

Objective To explore the effect of using abdominal pressure at different times and the second stage of labor on the delivery outcome of primiparas with labor analgesia.Methods A total of 400 primiparous women are admitted to our hospital from January 2019 to December 2019.All of them were randomly selected into control and observation groups.In the control group(n=200),the use of abdominal pressure is guided when the uterus is opened.In the observation group(n=200),the uterine orifice is opened and the fetus is first exposed 2.5~3 cm below the ischial spine,and the parturients use abdominal pressure when they have a full sense of breath-holding.The general conditions,fatigue after delivery,and delivery outcome are compared.Results There was no significant difference in labor fatigue between the two groups in the early stage of labor(P>0.05).The labor fatigue in the middle and late observation group was lower than that in the control group(P<0.05);the labor outcome of the observation group(postpartum hemorrhage,neonatal asphyxia,postpartum urinary retention,and postpartum flatulence)were all short in the control group(P<0.05).Conclusion For primiparas with labor analgesia,2.5~3 cm below the ischial spine is exposed during the fetal presentation.Using abdominal pressure when there is a sense of breath-holding can shorten the time of the second stage of labor and the time of using abdominal pressure.The fatigue of the parturient is lower in the middle and late stages of labor,and there are fewer adverse events.