新产程时限管理联合个性化音乐疗法在初产妇分娩过程中的应用及其对产时疼痛焦虑、产后盆底功能的影响

The application of new labor time limit management combined with personalized music therapy in primiparas and its influence on pain and anxiety during labor and pelvic floor function

目的从产时疼痛焦虑、母婴结局、产后盆底功能等方面探讨新产程时限管理结合个性化音乐疗法在初产妇分娩过程中的应用价值。方法选取2019年1月至2021年5月于北京市通州区中西医结合医院分娩的145例初产妇作为研究对象,按照随机数字表法分为常规产程组(n=48)、新产程组(n=48)、联合组(n=49),分别采用常规产程管理、新产程时限管理、新产程时限管理联合个性化音乐疗法。统计并比较三组的分娩方式、产时疼痛焦虑评分、母婴结局、产后盆底功能。结果联合组、新产程组阴道分娩率高于常规产程组,中转剖宫产率、母婴并发症总发生率低于常规产程组(P<0.05);联合组、新产程组阴道分娩率、中转剖宫产率及母婴并发症总发生率比较,差异无统计学意义(P>0.05)。联合组第一产程、第二产程Wong-Baker疼痛面部表情评估法及视觉模拟焦虑量表(VAS-A)评分低于新产程组、常规产程组,且新产程组低于常规产程组(P<0.05)。产后6周联合组、新产程组盆底肌峰值、活力值、功值大于常规产程组(P<0.05),联合组盆底肌功能与新产程组比较,差异无统计学意义(P>0.05)。结论新产程时限管理联合个性化音乐疗法可提高初产妇的阴道分娩率,缓解产时疼痛焦虑,减少母婴并发症的发生率,并改善其产后盆底功能情况。

Objective To explore the application value of new labor time management combined with personalized music therapy in primiparas from the aspects of labor time,maternal and infant outcome,and postpartum pelvic floor function.Methods A total of 145 primiparas from January 2019 to May 2021 in Tongzhou District Hospital of Integrated Traditional Chinese and Western Medicine in Beijing were selected and randomly divided into routine labor group(n=48),new labor group(n=48),and combined group(n=49),using conventional labor management,new labor time limit management,new labor time limit management+individualized music therapy,respectively.The mode of delivery,intrapartum pain and anxiety levels,maternal and infant outcomes,and postpartum pelvic floor function were recorded in the three groups.Results The rate of vaginal delivery was higher in the combined group and the new labor group than in the routine labor group,and the rate of intermediate cesarean delivery and the total incidence of maternal and infant complications were lower than those in the routine labor group(P<0.05);there was no statistically significant difference in the rate of vaginal delivery,the rate of intermediate cesarean delivery and the total incidence of maternal and infant complications between the combined group and the new labor group(P>0.05).The Wong-Baker pain facial expression assessment method and visual analogue anxiety scale(VAS-A)scores in the combined group during the first and second stage of labor were lower than those in the new labor group and the routine labor group,and the new labor group was lower than the routine labor group(P<0.05).The peak pelvic floor muscle,vitality value and work value were greater in the combined group and the new labor group than in the routine labor group at 6 weeks after delivery(P<0.05),and there was no statistically significant difference between the pelvic floor muscle function in the combined group and the new labor group(P>0.05).Conclusions Time-limited management of the new labor combined with individualized music therapy improves the rate of vaginal delivery in primiparous women,reduces pain and anxiety during labor,reduces the incidence of maternal and infant complications,and improves their postpartum pelvic floor function.