侧卧位花生球辅助干预联合自由体位助产对会阴裂伤严重程度及自我效能感的影响观察

Effect Observation of Lateral Position Peanut Ball Assisted Intervention Combined with Free Position Assisted Delivery on Severity and Self Efficacy of Perineal Laceration

目的分析侧卧位花生球辅助干预联合自由体位助产对会阴裂伤严重程度及自我效能感的影响。方法将2020年5月—2022年7月在本院妇产科接受自然分娩的60例产妇,按随机数字表法分为对照组和观察组,每组30例。对照组按传统分娩体位进行自然分娩,观察组在对照组的基础上给予侧卧位花生球辅助干预联合自由体位助产,比较两组产妇产后2h出血量、产程、会阴裂伤程度、自我效能感及分娩结局,比较两组新生儿结局。结果两组产后2h出血量对比,差异无统计学意义(P>0.05),但观察组第一产程、第二产程、第三产程时间较对照组短,差异有统计学意义(P<0.05)。两组会阴裂伤等级差异有统计学意义(P<0.05),观察组会阴裂伤≥Ⅱ度比例显著低于对照组,差异有统计学意义(P<0.05)。干预前,两组产妇CBSEI-C32量表结果期望、自我效能期望及总分差异无统计学意义(P>0.05);干预后,观察组产妇CBSEI-C32量表结果期望、自我效能期望及总分则较干预前显著上升,且观察组的CBSEI-C32量表结果期望、自我效能期望及总分显著高于对照组,差异有统计学意义(P<0.05)。两组未见产后出血发生,产妇中转剖宫产率、产前助产、会阴侧切比例及新生儿体重、身长、分娩后5min Apgar评分比较,差异无统计学意义(P>0.05)。结论侧卧位花生球辅助干预联合自由体位助产能有效降低产妇会阴裂伤严重程度,提高自我效能感,具有广泛应用价值。

Objective To analyze effect of lateral position peanut ball assisted intervention combined with free position assisted delivery on severity of perineal laceration and self efficacy.Methods The paper chose 60 parturients with delivery in obstetrics and gynecology department of our hospital from May 2020 to July 2022,and divided them into control group and observation group with random number table method,with 30 cases in each group.Control group was treated with natural delivery in traditional delivery position,while observation group with lateral peanut ball assisted intervention combined with free position assisted delivery on the basis of control group.Postpartum hemorrhage volume,labor process,degree of perineal laceration,self efficacy and delivery outcomes between two groups of parturients were compared,neonatal outcomes were compared between two groups.Results Difference in postpartum bleeding volume between two groups at 2 hours was not statistically significant(P>0.05),observation group had shorter first,second,and third stages of labor than control group(P<0.05).There was statistically significant difference in grade of perineal lacerations between two groups(P<0.05),proportion of perineal lacerations≥Ⅱdegree in observation group was significantly lower than control group(P<0.05).There was no statistically significant difference in expected results,self efficacy expectations,and total scores of CBSEI-C32 scale between two groups before intervention(P>0.05).After intervention,there was no statistically significant difference in expected CBSEI-C32 results,self efficacy expectations,and total scores of control group from before intervention,(P>0.05).Expected CBSEI-C32 results,self efficacy expectations,and total scores of observation group were significantly higher than before intervention(P<0.05).Expected CBSEI-C32 results,self efficacy expectations,and total scores of observation group were significantly higher than control group after intervention,difference was statistically significant(P<0.05).There was no postpartum hemorrhage observed in two groups,no statistically significant difference in conversion rate to cesarean section,prenatal midwifery,perineal lateral section ratio,newborn weight,length,and Apgar scores 5 minutes after delivery between two groups,(P>0.05).Conclusion Combination of lateral position peanut ball assisted intervention and free position assisted delivery can reduce severity of perineal laceration of parturients effectively,and improve self efficacy,which has great application value.