一对一责任制助产护理模式对初产妇分娩方式和产程的影响研究

Effect of One-to-one Responsibility System of Midwifery Care Mode on Primipara Delivery and Labor

目的探究和分析一对一责任制助产护理模式对初产妇分娩方式和产程的影响。方法选择兰溪市妇幼保健计划生育服务中心妇产科2017-01-01至2018-08-30收治的初产妇200例为研究对象。采用随机数字表法将其分为对照组和研究组,各100例。对照组采用常规助产护理模式干预,研究组采用一对一责任制助产护理模式干预。对比两组分娩方式(顺产、剖宫产),第一、二、三产程时间,产后2 h出血量,新生儿Apgar评分,母婴不良事件发生率。结果研究组顺产率(85.0%)高于对照组(61.0%)(P<0.05)。研究组第一、二产程时间﹝(5.1±1.0)、(0.6±0.3)h﹞短于对照组﹝(10.3±1.2)、(1.1±0.8)h﹞(P<0.05);研究组第三产程时间﹝(8.6±1.3)h﹞与对照组﹝(10.5±1.5)h﹞比较,差异无统计学意义(P>0.05)。研究组产后2 h出血量﹝(86.8±20.6)ml﹞少于对照组﹝(124.5±27.9)ml﹞,新生儿Apgar评分﹝(9.2±0.7)分﹞高于对照组﹝(7.3±0.8)分﹞(P<0.05)。研究组母婴不良事件发生率(2.0%)低于对照组(19.0%)(P<0.05)。结论对初产妇采用一对一责任制助产护理模式干预,不仅能提高产妇顺产率、缩短其总产程时间,还能减少其产后出血量、降低母婴不良事件发生率,对提高初产妇分娩质量和保障母婴安全具有重要意义。

Objective To explore and analyze the effect of one-to-one system of midwifery care mode on the delivery mode and labor of primipara.Methods Two hundred primiparas from the Department of Obstetrics and Gynecology of Lanxi City Maternal and Child Health Family Planning Service Center from January 1 st,2017 to August 30 th,2018 were selected as the study subjects.They were divided into the control group and the study group by random number table method,100 cases in each group.The control group was intervened by the routine midwifery care model.The study group used a one-to-one system of midwifery care mode intervention.The delivery mode(spontaneous delivery,cesarean section),the time of the first,second and third stages of labor,the amount of postpartum hemorrhage in 2 hours,the Apgar score of newborns and the incidence of adverse events of mother and infant were compared between the two groups.Results The spontaneous rate of study group(85.0%)was higher than that of control group(61.0%)(P<0.05).The first and second stages of labor in the study group﹝(5.1±1.0),(0.6±0.3)h﹞were shorter than those in the control group﹝(10.3±1.2),(1.1±0.8)h﹞(P<0.05).There was no significant difference in the third stage of labor between the study group﹝(8.6±1.3)h﹞and the control group﹝(10.5±1.5)h﹞(P>0.05).The amount of postpartum hemorrhage in the study group﹝(86.8±20.6)ml﹞was less than that in the control group﹝(124.5±27.9)ml﹞,and the Apgar score in the newborn(9.2±0.7)was higher than that in the control group(7.3±0.8)(P<0.05).The incidence of maternal and infant adverse events in the study group(2.0%)was lower than that in the control group(19.0%)(P<0.05).Conclusion Intervention of primiparas with one-toone responsibility for midwifery care mode can not only improve maternal vaginal yield and shorten the total labor time,but also reduce postpartum hemorrhage and reduce the incidence of adverse events of mother and infant.Therefore,it is of great significance to improve the quality of primipara delivery and to ensure maternal and child safety.