自由体位联合PCA对缓解初产妇分娩疼痛的效果分析  

Effect of free body position combined with PCA on relieving labor pain of primipara

作　　者：张利敏 ZHANG Limin(Obstetrics Department,Tongxu County Hospital of Traditional Chinese Medicine,Kaifeng,Henan 475400,China)

机构地区：[1]通许县中医院产科,河南开封475400

出　　处：《中国医学工程》2023年第6期105-108,共4页China Medical Engineering

摘　　要：目的探讨自由体位联合自控镇痛(PCA)对缓解初产妇分娩疼痛的效果。方法本文为前瞻性研究,选取2020年6月至2022年6月通许县中医院165例预期采用阴道自然分娩的初产妇,随机分为对照组(n=82)与研究组(n=83)。对照组采用PCA镇痛方法联合传统固定平卧体位进行经阴道自然分娩,研究组采用PCA联合无固定自由体位进行经阴道自然分娩。比较两组的分娩方式、产程持续时间、分娩过程的疼痛数字评估量表(NRS)评分、新生儿Apgar评分等指标。结果研究组的阴道自然分娩率(91.57%vs.69.51%)高于对照组,阴道助产分娩率(7.23%vs.20.73%)低于对照组,中转剖宫产率(1.20%vs.9.76%)低于对照组(P<0.05)。研究组的产程持续时间短于对照组(P<0.05),研究组新生儿的Apgar高于对照组,研究组PCA镇痛后1 h、2 h、宫口全开时、分娩时的NRS评分均低于对照组(P<0.05)。结论PCA联合自由体位分娩有助于缩短初产妇产程时间,提高产妇分娩舒适度,减轻分娩疼痛,改善分娩结局。【Objective】To investigate the effect of free posture combined with patient controlled analgesia(PCA)on relieving labor pain of primipara.【Methods】From June 2020 to June 2022,165 primipara expecting vaginal natural delivery in our hospital were selected and randomly divided into the control group and the study group,82 cases and 83 cases respectively.In the control group,PCA analgesia method combined with traditional fixed supine position was used for vaginal natural delivery.In the study,PCA combined with unfixed free position was used for vaginal natural delivery.The delivery mode,duration of labor,NRS score and Apgar score of newborn were compared between the two groups.【Results】The vaginal natural delivery rate in the study group(91.57%vs.69.51%)was higher than that in the control group,the vaginal assisted delivery rate(7.23%vs.20.73%)was lower than that in the control group,and the conversion rate to cesarean section(1.20%vs.9.76%)was lower than that in the control group(P<0.05).The duration of labor process in the study group was shorter than that in the control group(P<0.05),Apgar score of newborns in the study group was higher than that in the control group,and the NRS scores of the study group were lower at 1 hour,2 hours after PCA analgesia,at full opening of the cervix,and during delivery compared with the control group(P<0.05).【Conclusion】PCA combined with free body position delivery can shorten the labor process of primipara,improve the comfort of parturient,relieve labor pain,and improve the outcome of labor.

关 键 词：初产妇 分娩疼痛 镇痛分娩 自由体位 病人自控镇痛 

分 类 号：R714.3[医药卫生—妇产科学]