第二产程侧卧位适度保护会阴接生结合“1+1”分娩陪伴在初产妇阴道分娩中的应用  

Application of “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery

作　　者：侯晓丽 赵言 王瑞丽[1] 李秀明 邱迎军 HOU Xiaoli;ZHAO Yan;WANG Ruili;LI Xiuming;QIU Yingjun(Yuncheng Central Hospital,Shanxi Province,044000)

机构地区：[1]山西医科大学附属运城市中心医院,044000

出　　处：《中国计划生育学杂志》2024年第9期2099-2103,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨第二产程侧卧位适度保护会阴接生结合“1+1”分娩陪伴在初产妇阴道分娩中的应用效果。方法:收集2023年1-9月本院产科病房收治的100例产妇资料作为观察组,采用倾向性评分匹配法另选择100例采用常规接生产妇资料作为对照组,比较两组会阴受损情况、疼痛程度、分娩应激激素水平、分娩恐惧及孕产期心理社会适应情况。结果:观察组会阴侧切(12.0%)、会阴撕裂(44.0%)、会阴水肿(41.0%)发生率均低于对照组(24.0%、71.0%、59.0%),轻度疼痛占比(39.0%)高于对照组(25.0%),重度疼痛占比(13.0%)低于对照组(30.0%),肾上腺皮质激素、皮质醇水平(42.33±11.57 pmol/L、765.23±158.90 nmol/L)均低于对照组(49.52±9.85 pmol/L、808.15±114.28 nmol/L),Wijma分娩预期问卷评分(72.57±10.22分)低于对照组(81.35±9.72分),孕产期心理社会适应量表评分(44.33±8.47分)高于对照组(39.91±9.65分)(均P<0.05)。结论:分娩第二产程侧卧位适度保护会阴接生结合“1+1”分娩陪伴不仅能够降低阴道分娩初产妇会阴撕裂风险,减少分娩疼痛、降低分娩应激激素水平,缓解产妇恐惧心理有积极作用。Objective: To investigate the application effect of “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery. Methods: The data of 100 primiparas who accepted “1+1” delivery accompaniment combined with the appropriate protection of perineum during the second stage of primiparas with latericumbent posture in vaginal delivery(in research group) from January 2023 to September 2023 were collected, and the data of another 100 primiparas with routine delivery(in control group) selected by propensity score matching method were also collected. The situation of perineal damage, the pain degree, the labor stress hormone level, the labor fear and psycho-social adjustment situation of the primiparas were compared between the two groups. Results: The incidences of episiotomy(12.0%), the perineum tear(44.0%), the perineum edema(41.0%) of the primiparas in the research group were significantly lower than those(24.0%, 71.0% and 59.0%) of the primiparas in the control group. The proportion of mild pain(39.0%) of the primiparas in the research group was significantly higher than that(25.0%) of the primiparas in the control group, the proportion of severe pain(13.0%) of the primiparas in the research group was significantly lower than that(30.0%) of the primiparas in the control group. The levels of adrenal cortical hormone(42.33±11.57 pmol/L) and cortisol(765.23±158.90 nmol/L) of the primiparas in the research group were significantly lower than those(49.52±9.85 pmol/L and 808.15±114.28 nmol/L) of the primiparas in the control group. The Wijma childbirth expectancy questionnaire score(72.57±10.22 points) of the primiparas in the research group was significantly lower than that(81.35 ±9.72points)of the primiparas in the control group,and the maternal psychosocial adjustment scale score(44.33±8.47points)of the primiparas in the research group was significantly higher than that(39.91±9.65points)of the primipar

关 键 词：第二产程 侧卧位 适度保护会阴 “1+1”分娩陪伴 分娩痛 会阴损伤 心理 

分 类 号：R714.3[医药卫生—妇产科学]