激励式陪产对产妇应激反应的临床观察

Clinical Observation on Stress Reaction of Parturient towards Encouraging Accompanying Labor

目的 :探讨激励式陪产对产妇分娩时应激反应的影响。方法 :选择初产妇 82例 ,随机分为陪产组 48例、对照组 3 4例。陪产组在整个产程中由专门的助产士全程陪伴并给予心理支持 ;对照组按常规方式进行。两组分别于进入待产室前 3 0min、入待产室后 3 0min、宫口开全时、胎儿娩出后 3 0min、分娩后第 1天、第 3天抽取静脉血测定血浆儿茶酚胺(CA :NE、E)、血清皮质醇 (Cor)和血糖值。结果 :对照组进入待产室后至宫口开全 ,CA均明显升高 ,与陪产组相比有统计学意义(P <0 .0 5 )。Cor水平两组在宫口开全时均开始上升 ,分娩后第1天陪产组恢复较快 ,但对照组仍呈高皮质醇反应 ,与陪产组相比P <0 .0 5 ,分娩后第 3天仍高于陪产组 (P <0 .0 5 )。血糖变化两组基本相似 ,但对照组高血糖反应持续时间较长。结论 :激励式陪产方式可以消除产妇的精神紧张状态 ,加速CA、Cor在体内降解 ,并降低产妇的代谢率 。

Objective: to probe into the influence of encouraging accompanying labor on the stress reaction of parturient undergoing childbirth. Methods: a total of 82 primiparae were selected and divided into both test group (48 cases) and control groups (34 cases) randomly. Primiparae of test group had been accompanied by a midwife during their childbirth and psychological supports were given. Primiparae of control group were just given routinely care. Venous blood concentration of catecholamine (CA), cortisol (Cor), and glucose of all primiparae were detected 30 min before and after entering labor room, uterus orifice fully opened, 30 min, the 1st day, and the 3rd day after delivery respectively. Results: at the time primiparae entered the labor room until their uterus orifice fully opened, blood CA concentration of primiparae in control group was remarkably higher than that of primiparae in test group. There was statistical significant difference between the two groups (P<0.05). Blood Cor level of primiparae of the two groups increased when their uterus orifice fully opened. However, on the 1st day after delivery, blood Cor concentration of primiparae in test group decreased to the same level before entering labor room. Blood Cor concentration of primiparae in control group still showed high Cor reaction. There was statistical significance between the two groups (P<0.05). Primiparae of the two groups had similar blood glucose changes. But primiparae of control group lasted for longer time of high blood glucose reaction. Conclusion: encouraging accompanying labor may relieve the mental stress of primiparae. It could also accelerate the degradation of CA and Cor inside their body. It could both lower the basic metabolism rate of parturient and play an active role for their psychosomatic health.