二胎高龄产妇应用无痛分娩干预模式对分娩结局的影响分析

Effect analysis of painless delivery intervention mode on delivery outcome in advanced maternal age parturient with second pregnancy

目的 探究二胎高龄产妇应用无痛分娩干预模式对分娩结局的影响。方法 100例二胎高龄产妇,采用随机数字表法分为对照组和试验组,每组50例。对照组采用常规方式进行分娩,试验组采用无痛分娩干预模式进行分娩。比较两组产妇的产程时间、分娩时疼痛程度、心理状态、母婴结局、分娩方式。结果 试验组第一、第二产程时间及总产程时间分别为(402.36±85.67)、(45.25±12.30)、(457.36±36.98)min,均短于对照组的(615.47±69.13)、(61.38±11.29)、(682.44±51.29)min,差异具有统计学意义(P<0.05);试验组第三产程时间为(8.02±2.14)min,与对照组的(8.15±1.39)min比较差异无统计学意义(P>0.05)。试验组分娩时疼痛程度Ⅰ级41例,Ⅱ级4例,Ⅲ级4例,Ⅳ级1例,Ⅴ级0例;对照组分娩时疼痛程度Ⅰ级5例,Ⅱ级8例,Ⅲ级15例,Ⅳ级20例,Ⅴ级2例;试验组分娩时疼痛程度低于对照组,差异具有统计学意义(P<0.05)。分娩后,两组汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分均低于本组分娩前,且试验组HAMA评分(26.23±9.71)分、HAMD评分(25.29±7.46)分低于对照组的(30.46±7.50)、(28.73±8.02)分,差异有统计学意义(P<0.05)。试验组产后出血、胎儿窘迫发生率分别为2.00%、2.00%,低于对照组的14.00%、16.00%,差异有统计学意义(P<0.05);两组产褥感染、羊水重度污染、新生儿窒息发生率比较差异无统计学意义(P>0.05)。试验组自然分娩率78.00%高于对照组的56.00%,剖宫产率10.00%低于对照组的30.00%,差异有统计学意义(P<0.05);两组产钳助产率比较差异无统计学意义(P>0.05)。结论 二胎高龄产妇分娩中应用无痛分娩干预模式,可缩短产程时间,降低分娩时疼痛程度,改善分娩结局及产妇的心理状态,提高自然分娩率,意义重大。

Objective To investigate the effect of painless delivery intervention mode on delivery outcome in advanced maternal age parturient with second pregnancy.Methods A total of 100 advanced maternal age parturient with second pregnancy were divided into control group and experimental group by random numerical table,with 50 cases in each group.The control group was delivered in the conventional way and the experimental group was delivered in the painless delivery intervention model.The duration of labor,pain level during delivery,psychological state,maternal and infant outcomes,and mode of delivery were compared between the two groups.Results The time of first and second stages of labor and total stage of labor in the experimental group were(402.36±85.67),(45.25±12.30),and(457.36±36.98)min,which were shorter than(615.47±69.13),(61.38±11.29),and(682.44±51.29)min in the control group,and the differences were statistically significant(P<0.05).The time of third stage of labor in the experimental group was(8.02±2.14)min,and there was no statistically significant difference compared with(8.15±1.39)min in the control group(P>0.05).In the experimental group,41 cases had gradeⅠpain,4 cases had gradeⅡpain,4 cases had gradeⅢpain,1 case had gradeⅣpain,and 0 case had gradeⅤpain;in the control group,5 cases had gradeⅠpain,8 cases had gradeⅡpain,15 cases had gradeⅢpain,20 cases had gradeⅣpain and 2 cases had gradeⅤpain.The pain level during delivery in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).After delivery,the Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score in the two groups were lower than those before delivery in this group;the HAMA score of the experimental group was(26.23±9.71)points and the HAMD score was(25.29±7.46)points,which were lower than(30.46±7.50)and(28.73±8.02)points of the control group;all the differences were statistically significant(P<0.05).The incidence rates of postpartum hemorrhage and fetal distress in the experimental group were 2.00%and 2.00%,which were lower than 14.00%and 16.00%in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence rates of puerperal infection,severe amniotic fluid pollution and neonatal asphyxia between the two groups(P>0.05).The natural delivery rate 78.00%of the experimental group was higher than 56.00%of the control group,and the cesarean section rate 10.00%was lower than 30.00%of the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the forceps delivery rate between the two groups(P>0.05).Conclusion The application of painless labor intervention mode in advanced maternal age parturient with second pregnancy is significant in shortening the labor course,reducing the pain level during delivery,improving the delivery outcome and maternal psychological state,and increasing the natural delivery rate.