直立式分娩对自然分娩产妇产程时间及分娩结局的影响  

Effectiveness of upright delivery on duration of labor and delivery outcomes of natural childbirth

作　　者：王晨 靳静 李冕 周雪琴 Wang Chen;Jin Jing;Li Mian;Zhou Xueqin(Department of Obstetrical,Beijing New Century Women's and Children's Hospital,Beijing 100102,China)

机构地区：[1]北京新世纪妇儿医院产科,北京100102

出　　处：《护理学杂志》2024年第22期27-30,36,共5页Journal of Nursing Science

摘　　要：目的探讨直立式分娩方式在自然分娩中对产程时间及分娩结局的影响。方法选取2021年1月至2023年6月北京新世纪妇儿医院收治的正常临产且经阴道分娩的481例产妇作为研究对象。对照组为传统仰卧位分娩(n=339),观察组为直立式分娩(n=142)。分别比较两组初产妇和经产妇的产程时间、会阴裂伤程度、产后出血以及脐动脉血气的pH值、碱剩余、乳酸的差异性。结果观察组第一产程、第二产程及总产程时间显著短于对照组(均P<0.05)。观察组初产妇会阴侧切率显著低于对照组(P<0.05),两组会阴裂伤程度、产后出血比较差异无统计学意义(均P>0.05)。观察组初产妇新生儿脐动脉血气的pH、碱剩余和乳酸,经产妇新生儿pH值结果优于对照组,差异有统计学意义(均P<0.05)。结论直立式分娩方式能够帮助自然分娩的产妇缩短产程时间,降低新生儿酸中毒的发生概率,促进自然分娩,降低母婴不良结局的发生风险。Objective To explore the effects of upright delivery on the duration of labor and delivery outcomes of natural childbirth.Methods A total of 481 women with normal labor and vaginal delivery admitted to New Century Women's and Children's Hospital from January 2021 to June 2023 were selected as the study objects.The control group was delivered in the traditional supine position(n=339),while the observation group was delivered in the upright position(n=142).Differences in duration of labor,degree of perineal laceration,postpartum hemorrhage,and pH value,base remaining(BE),and lactate of the neonatalumbilical artery blood gas were compared between the primipara and multiparous women within the two groups,respectively.Results The time of the first stage of labor,the second stage of labor and the total labor in the observation group was significantly shorter than those in the control group(all P<0.05).The episiotomy rate in primiparas in the observation group was significantly lower than that in the control group(P<0.05),and there were no statistically significant differences in the degree of perineal laceration and postpartum hemorrhage between the two groups(both P>0.05).The pH value,BE,and lactate of neonatal umbilical artery blood gas in primiparas and the pH value of neonatal umbilical artery blood gas in multiparous in the observation group were better than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion The upright delivery method may assist women in natural delivery to shorten the duration of labor,reduce the incidence of neonatal acidosis,promote thenatural delivery,and decrease the risk of adverse outcomes for both mothers and infants.

关 键 词：产妇 自然分娩 直立式分娩 产程时间 会阴裂伤 脐动脉血气分析 分娩结局 

分 类 号：R473.71[医药卫生—护理学]