新产程标准及Friedman产程图在妊娠期糖尿病初产妇产程中的应用  

Application of New Labor Stage Criteria and Friedman Partogram in Gestational Diabetes Mellitus Primipara

作　　者：董明慧[1] DONG Minghui(Jiamusi City Maternal and Child Health Family Planning Service Center,Jiamusi 154000,China)

机构地区：[1]黑龙江省佳木斯市妇幼保健院计划生育服务中心

出　　处：《中国医学创新》2019年第28期19-23,共5页Medical Innovation of China

摘　　要：目的:研究对妊娠期糖尿病(gestational diabetes mellitus,GDM)初产妇采用新产程标准及Friedman产程图进行产程管理的效果。方法:从GDM初产妇中抽选260例纳入本次试验,试验对象入院时间均在2017年3月-2018年3月,根据病历单、双号将这260例患者分为旧产程组130例和新产程组130例,分别采用旧产程标准及Friedman产程图进行产程管理和新产程标准及Friedman产程图进行产程管理,统计两组产妇产程时间、医疗干预情况、分娩方式以及母婴并发症发生情况,并进行组间比较。结果:组间产妇第二产程时长、第三产程时长以及活跃期时长比较,差异均无统计学意义(P>0.05);新产程组潜伏期时长、总产程时长均分别长于旧产程组(t=2.668、2.162,P=0.008、0.032);组间医疗总干预率比较,新产程组48.46%低于旧产程组的65.38%(χ^2=5.838,P=0.016);组间阴道自然分娩率比较,新产程组68.46%高于旧产程组的55.38%(χ^2=4.804,P=0.043);组间剖宫产率比较,新产程组的8.46%低于旧产程组的19.23%(χ^2=4.862,P=0.027);组间母婴并发症总发生率比较,新产程组21.54%低于旧产程组的34.62%(χ^2=4.236,P=0.040)。结论:采用新产程标准及Friedman产程图对GDM初产妇进行产程管理,虽然会稍微延长产程时间,但是却可显著减少医疗干预,降低剖宫产率以及母婴并发症发生率。Objective:To study the application value of new labor stage criteria and Friedman partogram in gestational diabetes mellitus(GDM)primipara.Method:A total of 260 GDM primiparas delivered from March 2017 to March 2018 were selected and assigned to old group(n=130)and new group(n=130)according to odd or even medical record sheet number.The old group was managed through old labor stage criteria,the new group was given Friedman partogram.The labor time,medical intervention conditions,delivery modes,infant and maternal complications of two groups were counted.Result:The duration of second labor stage,third labor stage and new phase between groups showed not statistically significant difference(P>0.05).The duration of incubation stage and overall labor stage in new group was longer than that of old group(t=2.668,2.162;P=0.008,0.032).The overall intervention rate in new group(48.46%)was lower than that of old group(65.38%),the difference was statistically significant(χ^2=5.838,P=0.016).The natural delivery rate in new group(68.46%)was higher than that of old group(55.38%),the difference was statistically significant(χ^2=4.804,P=0.043).The Cesarean section rate in new group(8.46%)was lower than that of old group(19.23%),the difference was statistically significant(χ^2=4.862,P=0.027).The incidence rate of infant and maternal complications in new group(21.54%)was lower than that of old group(34.62%),the difference was statistically significant(χ^2=4.236,P=0.040).Conclusion:Although the labor stage is extended,the new labor stage criteria plus Friedman partogram can remarkably reduce the medical interventions,cesarean section rate,infant and maternal complications.

关 键 词：妊娠期糖尿病 初产妇 新产程标准 Friedman 产程图 产程管理 

分 类 号：R71[医药卫生—妇产科学]