第二产程延迟屏气对硬膜外分娩镇痛初产妇分娩结局的影响  

Effects of delayed pushing during second-stage labor on birth outcomes among nulliparous women with epidural anesthesia

作　　者：李一美[1] 邵慧静[1] 方晓红[1] 谢爱兰[1] 

机构地区：[1]温州医科大学附属第二医院产科，浙江 325000

出　　处：《中国护理管理》2016年第3期319-322,共4页Chinese Nursing Management

摘　　要：目的 :评价第二产程延迟屏气对硬膜外分娩镇痛的初产妇分娩结局的影响。方法 :将我院行硬膜外分娩镇痛的初产妇400例,随机分为实验组和对照组各200例,实验组采取延迟屏气的方法,对照组按常规在宫口开全时即指导产妇屏气。结果 :实验组第二产程时间比对照组长,用力屏气时间比对照组短,差异均有统计学意义(P<0.01);两组分娩方式、新生儿体质量及Apgar评分、会阴裂伤及侧切率比较,差异均无统计学意义(P>0.05);实验组产后出血量比对照组少,产后30min和产后2h的疲劳程度比对照组轻,差异有统计学意义(P<0.01)。结论 :硬膜外分娩镇痛初产妇第二产程延迟屏气可有效缩短用力屏气时间和产后出血量,对母婴不会产生不利影响,并可减轻产后疲劳。Objective： To evaluate the effect of delayed pushing during second-stage of labor on birth outcomes among nulliparous women with epidural anesthesia. Methods： Four hundred nulliparous women with epidural anesthesia were randomized to the delayed pushing group and immediate pushing group. The measured variables included the length of second-stage of labor, duration of pushing, type of delivery, Apgar scores, neonatal weight, perineal injuries, postpartum hemorrhage（PPH） and maternal fatigue. Results： The second-stage of labor was significantly longer and the duration of pushing was shorter in delayed pushing group than those in the immediate pushing group（P〈0.01）. There were no differences in type of delivery, Apgar scores, neonatal weight, perineal injuries and episiotomy between groups（P〈0.05）. The PPH volume was significantly lower in the delayed pushing group than that in the immediate pushing group（P〈0.01）. The results showed comparatively lower fatigue scores in the delayed pushing group at both half an hour and two hour postpartum（P〈0.01）. Conclusion： The delayed pushing for nulliparous women with epidural anesthesia during the secondstage labor could shorten the duration of pushing, PPH volume and postpartum fatigue without adverse outcome for mother and neonate.

关 键 词：镇痛 硬膜外 初产妇 产程 ?第二 延迟屏气 分娩 

分 类 号：R47[医药卫生—护理学]