新产程标准中产程时限管理对产妇分娩结局的影响  

Effect of management of labor duration based on the new labor process standard on the delivery outcome of parturient

作　　者：韩文莹 李丽霞[1] 李明巧 陈娜 李晓燕[1] 朱晓明 HAN Wenyin;LI Lixia;LI Mingqiao;CHEN Na;LI Xiaoyan;ZHU Xiaoming(The First Department of Obstetrics,the Second People's Hospital of Hengshui,Hengshui 053000,Hebei Province,China;Department of Obstetrics and Gynecology,Tangdu Hospital,Air Force Military Medical University,Xi'an 710038,Shaanxi Province,China)

机构地区：[1]衡水市第二人民医院产一科,河北衡水053000 [2]空军军医大学唐都医院妇产科,陕西西安710038

出　　处：《新乡医学院学报》2021年第5期418-421,426,共5页Journal of Xinxiang Medical University

基　　金：国家自然科学基金面上项目(编号:81471474);衡水市科学技术研究与发展计划项目(编号:2018014020Z)。

摘　　要：目的探讨新产程标准中产程时限管理对产妇分娩结局的影响。方法选择2016年2月至2018年8月于衡水市第二人民医院进行分娩的384例产妇为观察对象,采用随机抽签法分为观察组与对照组,每组192例。对照组产妇依据传统的产程时限标准进行产程管理,观察组产妇依据《新产程标准及处理的专家共识》中新的产程时限标准进行产程管理。2组产妇从规律宫缩开始进入产程,有镇痛需求者行分娩镇痛。比较2组产妇的分娩方式、产程时间、分娩疼痛情况、不良妊娠结局及满意度情况。结果对照组产妇行剖宫产、自然分娩、产钳分娩、会阴侧切者分别为58例(30.21%)、97例(50.52%)、5例(2.60%)、32例(16.67%),观察组产妇行剖宫产、自然分娩、产钳分娩、会阴侧切者分别为35例(18.23%)、120例(62.50%)、3例(1.56%)、34例(17.71%)。观察组产妇剖宫产率显著低于对照组,自然分娩率显著高于对照组(χ^(2)=7.506、5.605,P<0.05);2组产妇产钳分娩率、会阴侧切率比较差异无统计学意义(χ^(2)=0.511、0.073,P>0.05)。观察组产妇第一产程、第二产程、总产程时间均显著长于对照组(P<0.05)。对照组产妇行分娩镇痛者、未行分娩镇痛者视觉模拟评分(VAS)分别为3.16±0.40、7.10±1.42,观察组产妇行分娩镇痛者、未行分娩镇痛者VAS评分分别为2.32±0.34、6.22±1.23分;观察组行分娩镇痛者、未行分娩镇痛产妇的VAS评分均低于对照组(P<0.05)。对照组产妇发生产后出血9例(4.69%)、切口感染4例(2.08%)、会阴撕裂14例(7.29%)、胎儿宫内窘迫13例(6.77%)及新生儿窒息7例(3.65%),观察组产妇发生产后出血2例(1.04%)、切口感染2例(1.04%)、会阴撕裂2例(1.04%)、胎儿宫内窘迫2例(1.04%)及新生儿窒息3例(1.56%);观察组产妇产后出血、会阴撕裂、胎儿宫内窘迫及新生儿窒息发生率均显著低于对照组(χ^(2)=4.586、9.391、8.395、3.901,P<0.05)。对照组产妇十分Objective To explore the effect of the management of labor duration based on the new labor process standard on the delivery outcome of parturient.Methods A total of 384 parturients who gave birth at the Second People's Hospital of Hengshui from February 2016 to August 2018 were selected as the observation objects,and they were divided into the observation group and the control group by random drawing method,with 192 cases in each group.The parturients in the control group carried out labor management according to the traditional labor time limit standard;the parturients in the observation group carried out labor management according to the new labor time limit standard.The parturients in the two groups entered the labor process from regular contractions,and those who needed labor analgesia received labor analgesia.The delivery methods,time of each delivery process,pain of delivery,occurrence of adverse pregnancy outcomes and satisfaction of parturients in the two groups were compared.Results The parturients in the control group underwent cesarean section,natural delivery,forceps delivery and lateral perineal resection were 58 cases(30.21%),97 cases(50.52%),5 cases(2.60%)and 32 cases(16.67%)respectively.The parturients in the observation group underwent cesarean section,natural delivery,forceps delivery and lateral perineal resection were 35 cases(18.23%),120 cases(62.50%),3 cases(1.56%)and 34 cases(17.71%)respectively.The cesarean section rate of parturients in the observation group was significantly lower than that in the control group,and the natural delivery rate of parturients in the observation group was significantly higher than that in the control group(χ^(2)=7.506,5.605;P<0.05);there was no significant difference in the maternal forceps delivery rate and perineal lateral resecti on rate between the two groups(χ^(2)=0.511,0.073;P>0.05).The first stage,the second stage and total labor time of parturients in the observation group were significantly longer than those in the control group(P<0.05).The visual

关 键 词：新产程标准 产程时限 分娩结局 

分 类 号：R392[医药卫生—免疫学]