个体化产程管理对低危临产初产妇分娩结局的影响  

Impacts of individualized birth process management on birth outcomes of low-risk parturient unipara

作　　者：周红[1] 刘蓓[1] 陈莉[1] 雷霞[1] 梁珍丽 

机构地区：[1]杭州市第一人民医院妇产科,310006

出　　处：《中华现代护理杂志》2014年第8期906-908,共3页Chinese Journal of Modern Nursing

基　　金：2013年浙江省人口计生委经费自筹科研课题项目（JSW2013-B026）

摘　　要：目的探讨个体化产程管理对低危临产产妇分娩结局的影响。方法将729例临产产妇分为观察组503例和对照组226例。对照组采用自由体位待产，观察组对有难产倾向的产妇采用个体化产程运动和待产体位管理方法，增加母婴头盆顺应性，评价两组患者急诊剖宫产率及产钳使用率。结果观察组自然分娩例数468例，自然分娩率为93．04％，对照组自然分娩例数198例，自然分娩率为87．6％；观察组产钳使用率为1．59％，明显低于对照组的3．98％；观察组剖宫产例数为26例，剖宫产率为5．17％；对照组宫产例数19例，剖宫产率为8．41％，两组比较差异有统计学意义（χ^2=6．97，P=0．03）。观察组采用最多的待产姿势为半卧位，高达90．46％；采取比率最少的是蹲位，占4．57％。结论个体化产程管理能有效降低低危临床产妇急诊剖宫产率和产钳使用率。Objective To study the impact of individualized birth process management on birth outcomes of low-risk parturient unipara. Methods 729 parturient women were divided into the experimental group （ n = 503 ） and the control group （ n = 226）. The free position during labor was used in the control group. In the experimental group, individualized labor movements and pre-delivery positions were provided to improve the birth outcome. The incidence of emergency cesarean section and use of obstetric forceps were compared between groups. Results A total of 468 parturient women in the experimental group were in spontaneous labor, with an incidence of 93.04% ; 198 parturient women in the control group were in spontaneous labor, with an incidence of 87.6%. The use of obstetric forceps in the experimental group was 1.59% , which was lower than 3.98% in the control group. Twenty-six parturient women in the experimental group went through emergency cesarean section, with an incidence of 5.17% ; nineteen parturient women in the control group went through emergency cesarean section, with an incidence of 8.41%. The difference was significant between groups （χ^2 = 6. 97 ,P 〈0. 05）. The most frequent labor position in the experimental group was semireelining position, with an incidence of 90. 46%. The least use labor position was kneeling-squatting position, with an incidence of 4. 57%. Conclusions The Individualized birth process management can significantly decrease the rate of emergent cesarean and forceps delivery.

关 键 词：产妇 自然分娩 产程 体位 分娩结局 

分 类 号：R473.71[医药卫生—护理学]