静脉分娩镇痛初产妇全程导乐陪伴的效果研究

Doula delivery for primipara with intravenous labor analgesia

目的比较全程导乐陪伴和常规助产护理对静脉分娩镇痛的初产妇分娩结局的影响。方法收集2021年6月至2022年4月在浙江大学医学院附属儿童医院长兴分院行静脉分娩镇痛的80例初产妇,根据产妇意愿分为全程导乐陪伴助产护理组(观察组)和常规助产护理组(对照组),各40例。记录并比较两组产妇镇痛满意度评分、护理满意度评分、第一产程时间、第二产程时间、阴道分娩中转剖宫产率及麻醉不良反应的发生情况;记录并比较两组新生儿出生后1、5 min Apgar评分。结果相比对照组,观察组产妇镇痛满意度、护理满意度评分均显著升高(均P<0.05),中转剖宫产率和产程中呼吸抑制发生率均显著降低,差异均有统计学意义(均P<0.05)。两组间皮肤瘙痒、眩晕、恶心、呕吐等不良反应的发生率,第一产程时间、第二产程时间、新生儿1、5 min Apgar评分比较,差异均无统计学意义(均P>0.05)。结论相较于常规助产护理,全程导乐陪伴可以有效提高静脉分娩镇痛初产妇的镇痛、护理满意度,提高阴道分娩成功率,且不良反应少,值得临床推广。

Objective To investigate the effect of doula delivery for primipara with intravenous labor analgesia.Methods Eighty primipara who underwent intravenous labor analgesia in Changxing Branch of Children's Hospital Affiliated to Zhejiang University School of Medicine from June 2021 to April 2022,were divided into two groups according to the wishes of primiparas,40 cases received doula delivery(study group)and another 40 cases received routine midwifery nursing(control group).The analgesic satisfaction score,nursing satisfaction score,time of the first stage of labor,time of the second stage of labor,the rate of conversion to cesarean section during vaginal delivery and the occurrence of adverse reactions to anesthesia were compared between the two groups.Apgar scores were recorded and compared between the two groups at 1 and 5 min after birth.Results Compared with the control group,the analgesic satisfaction score and nursing satisfaction score in the study group were significantly increased(both P<0.05)and the rate of conversion to cesarean section during vaginal delivery and the occurrence of adverse reactions to anesthesia were significantly decreased(both P<0.05).There were no significant differences in the incidence of skin pruritus,vertigo,nausea and vomiting,the time of the first stage of labor,the time of the second stage of labor,and the Apgar score 1 and 5 min after birth between the two groups(all P>0.05).Conclusion Compared with routine midwifery nursing,the doula delivery can effectively improve the analgesia and nursing satisfaction,the success rate of vaginal delivery and have fewer adverse reactions in primipara with intravenous labor analgesia,which is worthy of clinical promotion.