无痛分娩术联合体位管理对产程进展影响研究

发布时间：2018-06-02 19:53

本文选题：分娩镇痛 + 体位管理　；参考：《中国实用妇科与产科杂志》2015年03期

【摘要】：目的探讨无痛分娩术联合体位管理加速产程进展的效果。方法选择2009年3月至2013年12月辽阳市第三人民医院产科住院待产、单胎头位要求行无痛分娩的初产妇200例,分为观察组100例和对照组100例。观察组采用体位管理:枕前位和枕横位时,取胎儿脊柱对侧卧位;枕后位时,取胎儿脊柱同侧卧位;宫口开全后,取半卧屈腿外展式。对照组不做体位指导,麻醉方式与观察组相同,孕妇可取自由舒适体位,直到宫口开全,第二产程取膀胱截石位,直到分娩结束。分别监测2组各产程的时间,计自然分娩、阴道助产和剖宫产产妇数量,测量产后出血量,计新生儿评分和新生儿出生体重。结果观察组与对照组相比,第一、二产程时间缩短[(366±32)min vs.(636±49)min,(42±11)min vs.(69±26)min,P0.05)],自然分娩率高(89.0%vs.72.0%,P=0.039),手术产率低(10.0%vs.23.0%,P=0.031),产后出血率低(1.0%vs.4.0%,P=0.027)、新生儿窒息率低(4.0%vs.9.0%,P=0.036)。结论无痛分娩术联合体位管理可以加速产程的进展,降低剖宫产率,对母儿有利。
[Abstract]:Objective to investigate the effect of painless labor union management on accelerating the progress of labor process. Methods from March 2009 to December 2013, 200 primipara who were hospitalized in the department of obstetrics of the third people's Hospital of Liaoyang City and who were given painless delivery in the first position of single fetus were divided into observation group (n = 100) and control group (n = 100). The observation group adopted position management: when occipital front position and occipital transverse position, take fetal spine opposite lateral position; occipital posterior position, fetuses spinal column same lateral position; after uterine opening, take half lie flexion leg extrapolation. The control group did not do body position guidance, anesthesia was the same as the observation group, pregnant women should be comfortable and free until the opening of the uterus, the second stage of labor to take bladder lithotomy position, until the end of labor. The time of each stage of labor, the number of spontaneous delivery, vaginal delivery and cesarean section, the amount of postpartum hemorrhage, the neonatal score and the birth weight of the newborn were measured. Results compared with the control group, the second stage of labor in the observation group was shorter than that in the control group (n = 366 卤32)min vs.(636 卤49min, 42 卤11)min vs.(69 卤26min, P 0.05), the rate of natural delivery was higher than that of the control group (89.0vs.72.0), the rate of operation was 10.0vs.23.0P0.031, the rate of postpartum hemorrhage was 1.0vs.4.0 P0.027m, the rate of neonatal asphyxia was 4.0vs.9.0v. Conclusion the combined position management of painless delivery can accelerate the progress of labor and reduce the rate of cesarean section, which is beneficial to mother and infant.
【作者单位】：辽宁省辽阳市第三人民医院;青岛市城阳人民医院;
【基金】：辽阳市科技局科研立项(201312)
【分类号】：R714.3

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