摘要
目的:探究椎管内镇痛联合导乐服务分娩在初产妇阴道分娩中效果。方法:选取复旦大学附属妇产科医院2019年7月至2020年2月期间产科接收的计划经阴道分娩的初产妇270例,采用随机数字表法分为两组,对照组135例产妇进行椎管内镇痛,观察组135例产妇在椎管内镇痛的基础上在产妇进入产程时进行导乐服务,比较两组产妇的产程时长、分娩疼痛情况、分娩结局、产后出血量、会阴切开率、母乳喂养率、新生儿窒息率和对护理满意度。结果:观察组产妇第一、第二产程时间均显著低于对照组产妇,产妇在分娩期视觉模拟评分法(VAS)评分显著低于对照组,组间差异显著(P<0.05);观察组产妇顺产率明显高于对照组,阴道助产率和顺转剖率均明显低于对照组,产后2 h内出血量也明显少于对照组,差异有统计学意义(P<0.05);观察组产妇会阴侧切率、新生儿窒息率均显著低于对照组,观察组母乳喂养率、产妇护理满意度显著高于对照组,差异有统计学意义(均P<0.05)。结论:椎管内镇痛联合导乐服务可有效缩短初产妇阴道分娩产程,减轻产妇分娩期疼痛,改善分娩结局,减少产后出血量,降低会阴侧切率,改善新生儿状况,提高产妇对护理的满意度。
Objective To explore the effect of intravertebral analgesia combined with doula service delivery in vaginal delivery of primiparas.Methods A total of 270 primiparas with planned vaginal delivery were selected from the department of obstetrics of the hospital from July 2019 to February 2020.The method of random number table was used to divide the patients into two groups.The control group(135 cases)received intravertebral analgesia,and the observation group(135 cases)received doula service when parturients entered labor on the basis of intravertebral analgesia.The duration of labor,labor pain,delivery outcome,postpartum blood loss,perineotomy rate,breasfeeding rate,neonatal asphyxia rate and satisfaction with nursing were compared between the two groups.Results First and second time labor of the observation group were significantly lower than the control group,matermal women in intrapartum visual analogue score(VAS)was significantly lower than the control group,and the differences were statistically significant(P<0.05).The rate of natural labour in the observation group was significantly higher than that in the control group,the rate of vaginal midwifery and the rate of anterograde section were significantly lower than that in the control group,and the amount of blood loss within 2 hours after delivery was also significantly lower than that in the control group,the differences were statistically significant(P<0.05).The rate of lateral perineal resection and neonatal asphyxia in the observation group were significantly lower than those in the control group,the breasfeeding rate and maternal nursing satisfaction in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Intravertebral analgesia combined with doula service can effectively shorten the vaginal labor process of primiparas,reduce the pain during labor,improve the outcome of childbirth,reduce postpartum bleeding and the rate of lateral perineal incision,improve
作者
蔡顺艳
孙英桢
陈露娇
Cai Shunyan;Sun Yingzhen;Chen Lujiao(LDR Ward,Obstetrics and Gynecology Hospital Afiliated to Fudan University,Shanghai 200011,China)
出处
《国际护理学杂志》
2023年第8期1437-1441,共5页
international journal of nursing
关键词
初产妇
阴道分娩
椎管内镇痛
导乐服务
Primiparas
Vaginal delivery
Intraspinal analgesia
Doula service
