不同自由体位在阴道分娩中的临床分析  

Clinical analysis of different free positions in vaginal delivery

作　　者：张婷[1,2] 李翠 董旭东 ZHANG Ting;LI Cui;DONG Xudong(Department of Obstetrical,the First People’s Hospital of Yunnan Province/the Affiliated Hospital of Kunming University of Science and Technology,Kunming,Yunnan 650500,China;School of Clinical Medicine,Dali University,Dali,Yunnan 671000,China)

机构地区：[1]云南省第一人民医院/昆明理工大学附属医院产科,昆明650000 [2]大理大学临床医学院,云南大理671000

出　　处：《重庆医学》2022年第18期3116-3119,共4页Chongqing medicine

基　　金：云南省院士专家工作站项目(202005AF150033);云南省卫生健康委员会高级人才项目(L-2018006)。

摘　　要：目的分析自由体位在阴道分娩中的实施情况及应用效果。方法选取2020年8月至2021年7月云南省第一人民医院165例成功自由体位分娩产妇为研究对象,根据分娩体位分为侧卧位组(n=33)、膝胸卧位组(n=45)和坐位组(n=87),另选取同期165例经传统膀胱截石位分娩的产妇作为对照组。比较各组视觉模拟疼痛评分(VAS)、产程时间、出血量、新生儿Apgar评分、会阴裂伤程度及侧切情况。结果165例自由体位分娩产妇均获得良好的分娩体验,且改变体位前后,侧卧位组、膝胸卧位组和坐位组VAS比较,差异有统计学意义(P<0.05)。侧卧位组、膝胸卧位组和坐位组第一、二产程时间短于对照组,差异有统计学意义(P<0.05),而出血量和新生儿1、5、10 min Apgar评分比较,差异无统计学意义(P>0.05)。4组均无Ⅲ、Ⅳ度会阴裂伤,侧卧位组、膝胸卧位组和坐位组的总侧切率(8.48%)明显低于对照组(29.09%),差异有统计学意义(P<0.05)。结论在产程中应用适宜自由体位可促进阴道分娩。Objective To analyze the implementation and effect of free position in vaginal delivery.Methods A total of 165 cases of successful free posture delivery in the First People’s Hospital of Yunnan Province from August 2020 to July 2021 were selected.According to the delivery posture,the parturients were divided into three groups:the lateral position group(n=33),the knee-chest position group(n=45)and the sitting position group(n=87).Another 165 parturients who were delivered in traditional bladder lithotomy position in the same period were selected as the control group.Visual analogue scale(VAS),the duration of labor,blood loss,neonatal Apgar score,perineal laceration and episiotomy were compared in each group.Results All the parturients with free posture had good delivery experience,and there were significant differences in VAS among the lateral position group,the knee-chest position group and the sitting position group before and after changing posture.The first and second stages of labor in the lateral position group,the knee-chest position group and the sitting position group were significantly lower than those in the control group(P<0.05),but there were no significant differences in blood loss and neonatal 1,5 and 10 min Apgar scores(P>0.05).There was no grade Ⅲ and Ⅳ perineal laceration in the four groups.The episiotomy rate in the lateral position group,the knee-chest position group and the sitting position group(8.48%)was lower than that in the control group(29.09%),and the difference was statistically significant(P<0.05).Conclusion The application of suitable free position during labor can promote vaginal delivery.

关 键 词：自由体位分娩 侧卧位 膝胸卧位 坐位 自然分娩 

分 类 号：R714.7[医药卫生—妇产科学]