第二产程分阶段自由体位分娩的临床研究  

Clinical study of the second stage of labor stage free position delivery

作　　者：王坤昌[1] 李桂平[2] 周秀荣[1] 彭晓娟 张慧茹 Wang Kunchang;Li Guiping;Zhou Xiurong;Peng Xiaojuan;Zhang Huiru(Department of Obstetrics,Hefei First People＇s Hospital,Hefei 230061,China)

机构地区：[1]合肥市第一人民医院产科,230061 [2]合肥市第一人民医院护理部,230061

出　　处：《中国实用护理杂志》2018年第29期2267-2271,共5页Chinese Journal of Practical Nursing

摘　　要：目的探讨第二产程分不同阶段采用自由体位分娩的临床效果，为临床助产工作提供依据。方法2016年3月至2017年11月，选取合肥市第一人民医院120例产妇为研究对象，利用随机数字表法分为研究组和对照组，每组60例。研究组第二产程分阶段采用自由体位分娩，对照组第二产程全程取仰卧膀胱截石位分娩。对比2组分娩结局、第二产程时长、产后2h阴道出血量、新生儿窒息率、会阴裂伤程度、会阴切开率、分娩舒适度和满意度及助产人员工作满意度。结果研究组阴道分娩率96．7％（58／60），高于对照组的86．7％（52／60），差异有统计学意义（χ^2=3．93，P〈0．05）。研究组第二产程时长（31．97±9．85）min，低于对照组的（39．50±12．19）min，差异有统计学意义（t=-3．257，P〈0．05）。2组新生儿窒息率、产后2h阴道出血量比较差异无统计学意义（P〉0．05）。研究组会阴完整率为10．4％（6／58），高于对照组的0；研究组会阴侧切率为0，低于对照组的21．1％（11／52），2组比较差异有统计学意义（χ^2=11．31、13．63，P〈0．05）。研究组分娩舒适度91．7％（55／60），分娩满意度100．O％（60／60），助产人员工作满意度100．0％（60／60）；高于对照组的38．3％（23／60）、83．3％（50／60）、76．7％（46／60），差异均有统计学意义（χ^2=37．51、10．91、15．85，P〈0．05）。结论第二产程分阶段自由体位分娩是有效安全的分娩方式，可提高自然分娩率，缩短第二产程，减轻会阴损伤，提高产妇分娩舒适度和满意度，也提升了助产人员工作满意度，且对母婴结局无不良影响，具有临床推广应用价值。Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People＇s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7% （58/ 60）, which was higher than that of the control group 86.7% （52/60）. The difference was statistically significant （χ^2=3.93, P〈0.05）. The duration of the second stage in the research group was （31.97±9.85） minutes, and that of the control group was （39.50±12.19） minutes. There was a statistically significant difference between the two groups （t = -3.357, P 〈 0.05）. There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups （P〉 0.05）. The perineum integrity rate in the research group was 10.4% （6/58）, higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1% （11/52）. The difference was statistically significant （χ^2=l 1.31, 13.63, P〈0.05）. Delivery comfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7% （55/60）, 100.0% （60/60） and 100.0% （60/60） respectively, while delivery comfort, delivery satisfaction and midwives job satisfac

关 键 词：第二产程 分阶段自由体位 垂直体位 侧卧位 

分 类 号：R473.71[医药卫生—护理学]