分娩镇痛初产妇产程中入量管理研究

Research on intake management in primipara labor analgesia during childbirth

目的 探讨饮食方式对分娩镇痛足月初产妇分娩结局的影响。方法 单胎足月初产妇400例随机分为观察组和对照组,观察组行入量管理及个体化的饮食指导。对照组根据孕妇的意愿进食水,比较2组分娩质量,初产妇呕吐,发生率、因宫缩乏力使用缩宫素率、产时发热率、会阴侧切率、转剖宫产率、阴道助产率、产后出血率;比较2组第一产程时间、第二产程时间、分娩镇痛时长及产后2 h出血量;比较2组新生儿Apgar评分、随机血糖、脐动脉血pH值、脐动脉血乳酸(Lac)值、新生儿窒息发生率、新生儿发热率、新生儿血糖异常发生率。结果 观察组产妇呕吐的发生率、因宫缩乏力使用缩宫素率、产时发热率、会阴侧切率、转剖宫产率、阴道助产率均低于对照组;观察组产后出血率、第一产程时间、第二产程时间、分娩镇痛时长及产后2 h出血量小于对照组,观察组新生儿高血糖的发生率和新生儿低血糖发生率低于对照组,差异均有统计学意义(P<0.05)。2组脐动脉血pH值、Lac值、新生儿Apgar评分、新生儿随机血糖、新生儿窒息率、新生儿发热率比较,差异无统计学意义(P>0.05)。结论 产程中对产妇进行入量管理及个体化的饮食指导可以减少宫缩乏力发生率,缩短产程持续时间,降低难产发生率,减少产后2 h出血量及降低新生儿血糖异常的发生率。

Objective To investigate the effect of dietary intake on the childbirth outcomes of primipara women with full-term labor analgesia.Methods A total of 400 primipara women with full-term labor analgesia were randomly divided into observation group and control group.The observation group received intake management and individualized dietary guidance,while the control group ate and drank according to their own wishes.The childbirth quality,the incidence of vomiting,the use of oxytocin due to uterine atony,the rate of intrapartum fever,the rate of perineal incision,the rate of cesarean section,the rate of vaginal assisted delivery,and the rate of postpartum hemorrhage were compared between the two groups.The duration of the first stage of labor,the duration of the second stage of labor,the duration of labor analgesia,and the amount of postpartum hemorrhage within 2 hours were also compared.Neonatal Apgar score,random blood glucose,umbilical artery blood pH value,umbilical artery blood lactic acid(Lac) value,the incidence of neonatal asphyxia,the incidence of neonatal fever,and the incidence of neonatal hypoglycemia were compared between the two groups.Results The observation group had lower incidences of vomiting,oxytocin use rate due to uterine atony,intrapartum fever rate,perineal incision rate,transferring cesarean section rate,and vaginal assisted delivery compared to the control group(P<0.05).The observation group had lower rates of postpartum hemorrhage,shorter duration of the first and second stages of labor,shorter duration of labor analgesia,and less postpartum hemorrhage within 2 hours compared to the control group,and the incidences of neonatal hyperglycemia and hypoglycemia in the observation group were lower than those in the control group( P < 0.05).There were no statistically significant differences in umbilical artery blood p H value,Lac value,neonatal Apgar score,random blood glucose,neonatal asphyxia rate,and neonatal fever rate between the two groups( P > 0.05).Conclusion Intake management and individualized dietary guidance during labor can reduce the incidence of uterine atony,shorten the duration of labor,decrease the incidence of dystocia,reduce postpartum hemorrhage within 2 hours and decrease the incidence of neonatal glucose abnormality.