分阶段体位管理结合自主屏气用力对初产妇产程、自我效能感及母婴结局的影响

Effects of phased position management combined with autonomous breath-holding force during labor of primiparas on their stages of labor, self-efficacy sensation, and maternal and infant outcomes

目的:探究分阶段体位管理结合自主屏气用力对初产妇产程、自我效能感及母婴结局的影响。方法:随机数表法将本院2018年6月—2020年6月拟行自然分娩的133例初产妇分为对照组67例与观察组66例,分别接受分阶段体位管理+常规指导用力、分阶段体位管理+自主屏气用力干预。对比两组产程时间、自我效能感、母婴结局等指标。结果:观察组各产程时间、总产程时间(432.0±100.8 min)与产妇自主用力时间(42.3±6.2 min)均短于对照组(508.8±105.2 min、58.8±10.4 min),第二产程时状态焦虑量表评分(44.35±4.12分)低于对照组(51.23±4.65分),自我效能感评分(35.34±5.70分)高于对照组(28.93±5.84分)(均P<0.05);宫缩乏力率、产后出血率、新生儿窒息率两组无差异(P>0.05),侧切助娩率观察组(9.1%)低于对照组(26.9%)(P<0.05)。结论:分阶段体位管理结合自主屏气用力能明显缩短初产妇产程,提高其自我效能感,降低会阴侧切率,值得临床进一步应用或改进。

Objective:To explore the effects of phased position management combined with autonomous breath-holding force during labor of primiparas on their stages of labor,selfefficacy sensation,and maternal and infant outcomes.Methods:133 primiparas who planned to natural delivery were divided into the control group(67 cases)and study group(66 cases)by the random number table method from June 2018 to June 2020.The primiparas in the control group were given phased position management combined with conventional guided force during labor,and the primiparas in the study group were given phased position management combined with autonomous breath-holding force during labor.The labor time,the self-efficacy sensation,the maternal and infant outcomes,and the other indicators of the primiparas were compared between the two groups.Results:The time of different stages of labor of the primiparas in the study group were significantly shorter than that of the primiparas in the control group.The total labor time(432.0±100.8 min)and the maternal voluntary force time(42.3±6.2 min)of the primiparas in the study group were significantly shorter than those(508.8±105.2 min and 58.8±10.4 min)of the primiparas in the control group.The score of state anxiety scale(44.35±4.12 points)of the primiparas in the study group was significantly lower than that(51.23±4.65 points)of the primiparas in the control group,and the score of self-efficacy sensation(35.34±5.70 points)of the primiparas in the study group was significantly higher than that(28.93±5.84 points)of the primiparas in the control group(all P<0.05).There were no significant differences in the rates of uterine fatigue and postpartum hemorrhage of the women,and the neonatal asphyxia between the two groups(P>0.05).The rate of midwifery by lateral incision(9.1%)of the primiparas in the study group was significantly lower than that(26.9%)of the primiparas in the control group(P<0.05).Conclusion:Phased position management combined with autonomous breath-holding force during the labor of the primiparas can significantly shorten their labor process,can improve their sense of self-efficacy,and can reduce their rate of lateral perineal incision for midwife,so which is worthy of further clinical application or improvement.