摘要
目的:分析导乐陪伴、自由体位、腰-硬联合麻醉分娩镇痛联合应用对促进自然分娩的效果。方法:将2017年4月-2019年3月住院分娩产妇根据自愿参加的原则随机分为观察组、镇痛组、导乐+体位组,每组200例,观察组给予导乐陪伴、自由体位及腰-硬联合麻醉镇痛。镇痛组只给予腰-硬联合麻醉镇痛,导乐+体位组采取导乐陪伴加自由体位分娩。观察三组产妇的疼痛评分(VAS)、麻醉药用量、产后2 h出血量、总产程时间、分娩方式、新生儿Apgar评分及新生儿窒息情况。结果:观察组疼痛评分(2.69±0.42)分,产后2 h出血(149.57±26.34)ml,麻醉药用量(34.32±7.56)ml,新生儿Apgar评分(9.51±0.25)分,均优于镇痛组及/或导乐+体位组,差异有统计学意义(P<0.05);观察组总产程用时较镇痛组及导乐+体位组更短,且自然分娩率更高,新生儿窒息发生率更低(P<0.05)。结论:导乐陪伴、自由体位、腰-硬联合麻醉分娩镇痛联合应用,能有效缓解孕妇分娩疼痛,缩短产程时间,减少产后出血,提高自然分娩率,降低剖宫产率,促进自然分娩。
Objective:To analyze the effect of Doula accompaniment,free posture,combined spinal-epidural anesthesia for labor analgesia on promoting natural delivery.Method:From April 2017 to March 2018,600 cases of parturient women in our hospital were divided into the observation group,the analgesia group,the Doula+body position group according to the order of admission,200 cases in each group.The observation group was given Doula,free position and combined spinal epidural analgesia,the analgesic group was given spinal-epidural anesthesia for analgesia,Doula+body position group was given doula accompanied and free position.Pain score(VAS),postpartum hemorrhage 2 hours,anesthetic dosage,neonatal Apgar score,total duration of labor,mode of delivery and neonatal asphyxia of the 3 groups were observed.Result:The pain score was(2.69±0.42)points,postpartum hemorrhage of 2 h was(149.57±26.34)ml, anesthetic dosage was(34.32±7.56)ml and neonatal Apgar score was(9.51±0.25)points in the observation group,better than those in the analgesia group and Doula+body position group,there were statistical significance(P<0.05).The total labor duration of observation group was shorter than that of the analgesia group and Doula+body posture group,and the natural delivery rate was higher,and the incidence of neonatal asphyxia was lower(P<0.05).Conclusion:Doula accompanying,free posture and combined spinal-epidural anesthesia for labor analgesia can effectively alleviate labor pain,shorten labor time,reduce postpartum hemorrhage and analgesic dosage,and improve the natural delivery rate.
作者
尹悦
李艳梅
董莎娜
YIN Yue;LI Yanmei;DONG Shana(Dalingshan Hospital of Dongguan,Dongguan 523820,China)
出处
《中外医学研究》
2019年第20期10-12,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
东莞市社会科技发展一般项目(项目编号:201650715001044)
关键词
导乐陪伴
自由体位
腰硬麻醉
分娩镇痛
自然分娩
Doula accompaniment
Free posture
Spinal-epidural anesthesia
Labor analgesia
Natural childbirth