分娩球自由体位助产联合分娩镇痛仪对初产妇产痛的影响.pdf
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1、14CHINA HEALTH STANDARD MANAGEMENT,Vol.14,No.17分娩球自由体位助产联合分娩镇痛仪对初产妇产痛的影响王银萍 权婷 薛芳莉作者单位:徐州市中心医院产科,江苏 徐州 221000通信作者:权婷分娩是多数女性所经历的特殊生理阶段,指胎儿脱离母体作为独立个体的过程,产程包括宫口扩张期、胎儿娩出期及胎盘娩出期,此过程产妇面临着较大的生理疼痛,且疼痛时间较长,可对产妇生理、心理健康产生影响,进而影响分娩结局1。初产妇缺乏分娩经验,未能掌握正确发力方式,分娩时易发生宫缩乏力,导致不良妊娠结局。此外,多数初产妇于分娩前存在不同程度负性情绪,如紧张、【摘要】目的 分析
2、初产妇应用分娩球自由体位助产联合分娩镇痛仪对产痛、分娩结局的影响。方法 选取2021年1月2022年12月于徐州市中心医院产科分娩的98例初产妇,按照随机数字表法分组。对照组(49例)行分娩球自由体位助产,研究组(49例)在对照组基础上联合分娩镇痛仪。比较两组的产痛程度、产程时间、分娩方式、疼痛介质、疲乏程度及不良妊娠结局。结果 研究组疼痛数字评分法(pain digital scoring method,NRS)评分为(5.111.06)分,低于对照组的(6.771.15)分,差异有统计学意义(t7.429,P 0.05)。研究组第一、第二、第三及总产程时间分 别 为(385.453.45)
3、min、(50.443.16)min、(5.220.36)min及(442.1510.69)min,短于对照组的(408.566.55)min、(63.454.12)min、(6.551.01)min及(486.9815.36)min(P 0.05)。研究组剖宫产率(6.12%)低于对照组(22.45%),差异有统计学意义(2 5.333,P 0.05)。研究组干预后前列腺素 E2(prostaglandin E2,PGE2)、P 物质(substance P,SP)水平低于对照组(P 0.05)。两组 5-羟色胺(5-hydroxytryptamine,5-HT)水平比较,差异无统计学意义(
4、P 0.05)。研究组干预后脑力疲乏、躯体疲乏评分低于对照组(P 0.05)。研究组不良妊娠结局率(6.12%)低于对照组(28.57%),差异有统计学意义(2 8.611,P 0.05)。结论 初产妇应用分娩球自由体位助产联合分娩镇痛仪,有利于减轻产妇产痛,降低剖宫产率,促进妊娠结局改善,并缩短产程时间。【关键词】分娩球自由体位助产;初产妇;疼痛程度;分娩镇痛仪;分娩结局;剖宫产;5-羟色胺【中图分类号】R714 【文献标识码】A【文章编号】1674-9316(2023)17-0014-04doi:10.3969/j.issn.1674-9316.2023.17.004The Effect
5、of Delivery Ball Free Position Assisted Delivery Combined With Delivery Analgesia Device on the Pain of Primiparous Women During ChildbirthWANG Yinping QUAN Ting XUE Fangli Department of Obstetrics,Xuzhou Central Hospital,Xuzhou Jiangsu 221000,ChinaAbstract Objective To analyze the impact of using d
6、elivery ball free body position assisted delivery combined with delivery analgesia device on labor pain and delivery outcomes in primiparous women.Methods A total of 98 primiparous women who gave birth in obstetrics from January 2021 to December 2022 of department of obstetrics,Xuzhou Central Hospit
7、al were selected and divided into two groups by a random number table method.The control group received 49 cases of free body delivery with delivery balls,while the study group received 49 cases of combined delivery analgesia on the basis of the control group.The degree of labor pain,duration of lab
8、or,delivery method,pain medium,fatigue level,and adverse pregnancy outcomes were compared between the two groups.Results The pain digital scoring method(NRS)score of the study group was(5.111.06)points,lower than the control groups(6.771.15)points,the difference was statistically significant(t=7.429
9、,P 0.05).The first,second,third,and total duration of labor in the study group were(385.453.45)minutes,(50.443.16)minutes,(5.220.36)minutes,and(442.1510.69)minutes,respectively,which were shorter than those in the control group(408.566.55)minutes,(63.454.12)minutes,(6.551.01)minutes,and(486.9815.36)
10、minutes(P 0.05).The cesarean section rate of 6.12%in the study group was lower than that of 22.45%in the control group,the difference was statistically significant(2=5.333,P 0.05).After intervention,the levels of prostaglandin E2(PGE2)and substance P(SP)in the study group were lower than those in th
11、e control group(P 0.05).After intervention,the scores of mental fatigue and physical fatigue in the research group were lower than those in the control group(P 0.05).The adverse pregnancy outcome rate of 6.12%in the study group was lower than that of 28.57%in the control group,the difference was sta
12、tistically significant(2=8.611,P 0.05).Conclusion The application of delivery ball free body position assisted delivery combined with delivery analgesia device in primiparous women is beneficial for reducing labor pain,reducing cesarean section rate,promoting improvement of pregnancy outcomes,and sh
13、ortening the delivery process time.Keywords birthing ball free position midwifery;primipara;the degree of pain;labor analgesic instrument;delivery outcome;caesarean section;serotonin15中国卫生标准管理CHSM 17恐惧、抑郁、焦虑等,不仅可增加机体对疼痛敏感度,还可延长产程时间,进而影响妊娠结局2。由此,对初产妇给予助产干预,对改善妊娠结局意义重大。分娩球自由体位助产是一种新型助产模式,其中分娩球作为助产器械的一
14、种,可通过帮助产妇活动身体、调整体位等,达到促进分娩、缓解疼痛等目的;而自由体位助产则可让产妇自行选择舒适体位,并利用分娩球进行活动,不仅可加速产程,还可减轻疼痛3-5。分娩镇痛仪是一种无创助产方式,以神经传导原理作为理论基础,利用一定频率的脉冲刺激,可对阿片肽等镇痛物质合成及分泌产生促进作用,同时抑制交感神经兴奋,镇痛效果显著6-7。本研究选取2021年1月2022 年 12 月于徐州市中心医院产科分娩的 98 例初产妇,分析初产妇应用分娩球自由体位助产联合分娩镇痛仪对产痛、分娩结局的影响,报道如下。1 资料与方法1.1 一般资料选取 2021 年 1 月2022 年 12 月于徐州市中心医
15、院产科分娩的 98 例初产妇。纳入标准:(1)单胎妊娠。(2)足月分娩。(3)年龄 22 35 岁。(4)病历资料完整。排除标准:(1)骨盆解剖结构异常者。(2)合并妊娠并发症者。(3)胎位不正、早产儿、前置胎盘者。(4)存在产道畸形者。(5)合并精神疾病者。按照随机数字表法分为两组,对照组 49 例,年龄 22 33 岁,平均(28.492.21)岁;孕周37 41 周,平均(39.541.21)周;文化水平:初中及以下11例,高中及中专18例,大专及以上20例。研究组49例,年龄 23 35 岁,平均(28.742.32)岁;孕周 37 41周,平均(39.451.16)周;文化水平:初中
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- 分娩 自由 体位 助产 联合 镇痛 初产妇 影响