时距式放松训练对阴道分娩产妇分娩疼痛、产程和心理状态影响

Effects of spaced relaxation training during vaginal delivery of women on their delivery pain,labor process,and psychological state

目的:探讨时距式放松训练对阴道分娩产妇分娩疼痛、产程和心理状态的影响。方法:选取2021年2月-2022年1月本院产科行阴道分娩初产妇110例,按照产妇选择镇痛方式的不同分为对照组和观察组各55例。宫口开至2cm后,对照组采取硬膜外自控镇痛(PCEA),观察组采取时距式放松训练。比较两组疼痛情况、各产程用时、分娩舒适度[舒适度量表(GCQ)及分娩控制感[分娩控制感量表(LAS)、心理状态[状态焦虑量表(S-AI)、焦虑自评量表(SAS)]及分娩结局。结果:干预后,两组单次阵痛痛觉时距、单次阵痛心率变化时距及VAS评分均较干预前下降,但观察组单次阵痛痛觉时距(32.15±9.12s)、单次阵痛心率变化时距(33.98±10.79s)、VAS评分(5.26±1.47分)均高于对照组(29.34±7.64s、31.75±10.64s、2.51±0.83分),第二产程(60.25±13.14分)短于对照组(66.24±15.24分),分娩时GCQ(80.42±10.21分)及LAS评分(168.48±20.12分)均高于对照组(66.84±8.95分、142.15±16.34分),S-AI(40.19±4.58分)及SAS评分(46.26±4.76分)均低于对照组(43.37±4.75分、48.47±5.12分),缩宫素使用率(11.5%)及阴道助产分娩率(1.9%)低于对照组(52.0%、14.0%),产后2h出血量(167.4±37.5ml)少于对照组(196.5±43.2ml)(均P<0.05)。结论:时距式放松训练对阴道分娩初产妇具有较好效果,能有效减轻产妇分娩疼痛和焦虑感,缩短第二产程,提高产妇分娩舒适度和分娩控制感,减少产科干预,从而改善分娩结局。

Objective:To explore the effects of spaced relaxation training during vaginal delivery of women on their delivery pain,labor process,and psychological state.Methods:From February 2021to January 2022,110primiparas who wanted vaginal delivery were selected and were divided into control group and observation group(55cases in each group)according to the maternal choice of analgesia.After the cervix opened to 2cm,the primiparas in the control group received patient-controlled epidural analgesia(PCEA),and the primiparas in the observation group received time?distance relaxation training.The pain situation,the duration of each stage of labor,the delivery comfort evaluated by General Comfort Questionnaire(GCQ),and the delivery control evaluated by live birth control scale(LAS),the psychological status evaluated by state anxiety scale(S-AI)and self-rating anxiety scale(SAS),and the delivery outcomes of the primiparas were compared between the two groups.Results:After intervention,the single pain duration,the heart rate change in single pain duration and the VAS score of the primiparas in the two groups after intervention had decreased significantly.The single pain duration(32.15±9.12s),the heart rate change duration in single pain(33.98±10.79s),and the VAS score(5.26±1.47points)of the primiparas in the observation group were significantly higher than those(29.34±7.64s,31.75±10.64s,and 2.51±0.83points)of the primiparas in the control group(P<0.05).The duration of the second stage of labor(60.25±13.14 min)of the primiparas in the observation group was significantly shorter than that(66.24±15.24min)of the primiparas in the control group.The scores of GCQ(80.42±10.21points)and LAS(168.48±20.12points)of the primiparas in the observation group were significantly higher than those(66.84±8.95points and 142.15±16.34points)of the primiparas in the control group.The S-AI score(40.19±4.58points)and the SAS score(46.26±4.76points)of the primiparas in the observation group were significantly lower than those(43.37±4.75points and 48.47±5.12points)of the primiparas in the control group.The rate of oxytocin used(11.5%)and the rate of vaginal delivery of midwifery(1.9%)of the primiparas in the observation group were significantly lower than those(52.0%and 14.0%)of the primiparas in the control group.The amount of postpartum bleeding(167.4±37.5ml)of the primiparas in the observation group was significantly less than that(196.5±43.2 ml)of the primiparas in the control group(all P<0.05).Conclusions:Spaced relaxation training during vaginal delivery of the primiparas has better effect,which can reduce the pain and anxiety,shorten the second stage of labor,and improve the comfort and control of the primiparas,and which can reduce the obstetric intervention,so as to improve the delivery outcomes of the primiparas.