探究无痛分娩联合接生手法改变对妊娠高血压孕妇顺产母婴结局及SAS评分的影响  

To explore the effect of changes in painless delivery combined with delivery techniques on the maternal and infant outcome of pregnancy-induced hypertension and the SAS score

作　　者：殷秀莉 杨小妹[1] 吕翠[1] 冯颖[1] 武启芸 冯小明[1] YIN Xiu-li;YANG Xiao-mei;LYU Cui(Department of Obstetrics,Tangshan Maternal and Children Health Hospital,Tangshan Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院产科,河北唐山063000

出　　处：《临床和实验医学杂志》2021年第8期879-883,共5页Journal of Clinical and Experimental Medicine

基　　金：2020年度河北省医学科学研究课题计划项目(编号:20201469)。

摘　　要：目的探究无痛分娩联合接生手法改变对妊娠高血压孕妇顺产母婴结局及自拟焦虑问卷(SAS)评分的影响。方法回顾性选取2019年6月至2020年9月唐山市妇幼保健院治的132例妊娠高血压综合征首选顺产分娩的产妇为研究对象,按照产妇采取的分娩接生手法不同分为观察组和对照组,每组产妇66例。2组产妇均采取硬膜外麻醉无痛分娩,对照组给予传统接生手法,观察组给予无会阴保护接生手法。记录2组产妇分娩方式及产中情况,分娩后产妇会阴损伤情况,产后2 h出血量,产后2、24、48 h疼痛情况,产后焦虑情况以及母婴结局。采用视觉模拟评分法(VAS)评定疼痛程度,采用SAS评分评定焦虑情况。结果2组产妇均成功自然分娩,观察组产妇第二产程时间、拨露5 cm至胎儿娩出时间分别为(10.17±4.95)、(31.24±8.93)、(5.21±2.02)min,显著优于对照组[(11.78±4.96)、(39.58±10.62)、(7.79±2.06)min],差异均有统计学意义(P<0.05)。观察组产妇Ⅰ度及以下会阴裂伤的产妇比率(72.73%)显著高于对照组(45.45%),Ⅱ度会阴裂伤、会阴侧切的产妇比率(18.18%、9.09%)显著低于对照组(25.76%、28.79%),差异有统计学意义(P<0.05)。2组产妇产后2 h VAS评分比较[(3.76±0.83)分vs.(3.73±0.86)分],差异无统计学意义(P>0.05);观察组产妇产后24、48 h VAS评分为(4.61±0.73)、(3.53±0.47)分,均显著低于对照组[(5.28±0.88)、(4.67±0.62)分],差异有统计学意义(P<0.05)。观察组产后2 h出血量[(139.74±19.26)mL]、SAS评分[(27.08±3.75)分]均显著低于对照组[(205.37±23.61)mL、(39.22±4.28)分],差异均有统计学意义(P<0.05)。观察组的新生儿出生1 min Apgar评分、新生儿呼吸窘迫发生率、产妇并发症发生率分别为(9.57±0.39)分、1.52%、4.55%,均优于对照组[(8.49±0.42)分、9.09%、15.15%],差异均有统计学意义(P<0.05)。结论无痛分娩过程中,与传统接生手法相比,无会阴保护接生手法改变对妊娠高�Objective To explore the effect of painless delivery combined with birth control on the maternal and infant outcome of pregnancy-induced hypertension and self-rating anxiety scale(SAS)score.Methods A retrospective selection of 132 pregnant women with pregnancy-induced hypertension who were treated in the Tangshan Maternal and Child Health Hospital from June 2019 to September 2020,who gave birth to cisternly,was selected as the research object.According to the different delivery methods adopted by the women,they were divided into observation group and control group,each group 66 patients.The mothers in the two groups were given epidural anesthesia for painless delivery.The control group was given the traditional delivery technique,and the observation group was given the non-perineal protection delivery techniques.The delivery methods and conditions of the mothers in the two groups,the perineal injury after delivery,the amount of bleeding at 2 h after delivery,the pain at 2,24,and 48 h after delivery,the anxiety after delivery,and the maternal and infant outcome were recorded.Pain was assessed by the visual analog scale(VAS),and anxiety was assessed by the SAS.Results The mothers in the two groups gave birth successfully.The time from the second stage of labor and the time from exposure of 5 cm to the delivery of the fetus in the observation group were(10.17±4.95),(31.24±8.93),and(5.21±2.02)min,which were significantly better than those of the control group[(11.78±4.96),(39.58±10.62),(7.79±2.06)min],the differences were statistically significant(P<0.05).In the observation group,the ratio of women with gradeⅠperineal laceration(72.73%)was significantly higher than that of the control group(45.45%),and the ratio of women with degreeⅡperineal laceration and perineal lateral incision(18.18%,9.09%)were significantly lower than that of the control group(25.76%,28.79%),the difference was statistically significant(P<0.05).There was no significant difference in VAS scores of the two groups at 2 h postpartum[(3.76�

关 键 词：无痛分娩 妊娠高血压综合征 接生手法改变 母婴结局 SAS评分 

分 类 号：R714.3[医药卫生—妇产科学] R714.246[医药卫生—临床医学]