指导性多体位改变配合穴位按压下自由体位分娩在胎方位不正产妇的应用效果研究  

Application effect of guided multi-position change combined with free position delivery under acupressure on puerperae with abnormal fetal position

作　　者：黄鹏美 王小华 夏碧军 Huang Peng-mei;Wang Xiao-hua;Xia Bi-jun(Shangrao Municipal Hospital,Shangrao 334000,Jiangxi,China;Guixi People’s Hospital,Yingtan 335000,Jiangxi,China)

机构地区：[1]上饶市立医院,江西上饶334000 [2]贵溪市人民医院,江西鹰潭335000

出　　处：《四川生理科学杂志》2024年第7期1446-1448,1483,共4页

基　　金：江西省卫生健康委科技计划(编号:202312341)。

摘　　要：目的:研究指导性多体位改变配合穴位按压下自由体位分娩在胎方位不正产妇中的效果。方法:将2022年1月至2023年6月于本院进行分娩的60例胎方位不正产妇随机分为体位改变组(指导性多体位改变待产、自由体位分娩)与穴位按压组(体位改变组基础上加以穴位按压),每组各30例。记录两组产妇围产期指标,采用阿氏评分(Appearance pulse grimace activity respiration,Apgar)评价新生儿窒息情况,采用简化舒适状况量表(General comfort questionnaire,GCQ)评价产妇舒适度,采用视觉模拟评分(Visual analogue scale,VAS)评价疼痛情况,采用爱丁堡产后抑郁量表(Edinburgh postnatal depression,EPDS)评价产后精神状态。结果:穴位按压组自然分娩率、胎头转正率、Apgar与GCQ评分均显著高于体位改变组(P<0.05),不良分娩结局发生率、第一产程时间、总生产时间、产后2 h阴道出血量、各产程VAS评分与EPDS评分均显著低于体位改变组(P<0.05)。结论:指导性多体位改变配合穴位按压下自由体位分娩能有效提升胎方位不正产妇自然生产率,缩短产程,改善产妇舒适度及母婴结局。Objective:To investigate the efficacy of the combination of guiding multiple body position changes and acupoint pressure during free body position delivery in parturients with malpositioned fetuses.Methods:Sixty women with malposition of the fetus who gave birth in our hospital from January 2022 to June 2023 were randomly divided into a postural change group(guided multidirectional postural changes for labor and free postural delivery)and an acupoint pressure group(postural change group plus acupoint pressure),with 30 cases in each group.Perinatal indicators were recorded for both groups of women,and neonatal asphyxia was evaluated using the Appearance Pulse Grimace Activity Respiration(Apgar)score.The comfort of the women was evaluated using the General Comfort Questionnaire(GCQ),and the pain was evaluated using the Visual Analogue Scale(VAS).The postpartum mental state was evaluated using the Edinburgh Postnatal Depression Scale(EPDS).Results:The acupoint pressure group had significantly higher natural delivery rates,fetal head rotation rates,Apgar and GCQ scores than the position change group(P<0.05),and had significantly lower rates of adverse delivery outcomes,first stage of labor time,total labor time,vaginal bleeding volume 2 hours after delivery,VAS scores during each stage of labor,and EPDS scores than the position change group(P<0.05).Conclusion:Guiding multi-position changes combined with acupoint pressure under free body position delivery can effectively improve the natural birth rate of pregnant women with abnormal fetal position,shorten the labor process,improve maternal comfort and maternal-child outcomes.

关 键 词：胎方位不正 指导性多体位改变 穴位按压 自由体位分娩 舒适度 新生儿窒息 

分 类 号：R473.71[医药卫生—护理学]