自由体位配合硬膜外分娩镇痛对初产妇第二产程、阴道分娩率及分娩疼痛感的影响  

Effects of the free position combined with epidural analgesia for labor analgesia of primiparaes on their second stage of labor,vaginal delivery rate and labor pain

作　　者：陈迪美 沈叶琴 吴朝勇 CHEN Dimei;SHEN Yeqin;WU Zhaoyong(Keqiao Women and Children's Hospital,Shaozing,Zhejiang Province,312030)

机构地区：[1]浙江省绍兴市柯桥区妇幼保健院,312030

出　　处：《中国计划生育学杂志》2025年第1期79-84,共6页Chinese Journal of Family Planning

摘　　要：目的:探究自由体位配合硬膜外分娩镇痛对初产妇分娩第二产程、阴道分娩率及分娩疼痛感的影响。方法:选取2023年1-6月本院收治的初产妇,依据试产干预方案不同分为观察组与常规组,观察组接受自由体位配合硬膜外分娩镇痛,常规组接受常规阴道试产,经倾向性匹配评分法排除基线资料混杂因素后,两组各获得105例初产妇,对比两组产程时间、分娩疼痛程度(发作开始第2h、宫口全开时、胎头拨露时)、分娩方式(阴道分娩、顺转剖、侧切率)、产后恢复情况(产后2h出血量、初次母乳喂养时间)、分娩控制感量表(LAS)评分、产后抑郁量表(EPDS)评分、产后舒适状况量表(GCQ)评分以及产妇满意度。结果:观察组第一、二、三产程及总产程时间(8.65±2.48h)均低于常规组(12.85±2.63h),阴道分娩率(100.0%)高于常规组(96.2%),产后恢复情况优于常规组,发作后第2h、产妇宫口全开时、胎头拨露时分娩疼痛VAS评分(4.14±0.66分、4.67±0.43分、3.37±0.34分)均低于常规组(5.23±0.75分、7.39±0.74分、5.64±0.68分),LAS评分(148.54±12.36分)高于常规组(140.46±10.35分),EPDS评分(9.35±1.97分)低于常规组(12.02±2.36分),GCQ各维度评分均高于常规组,满意率(86.7%)高于常规组(66.7%)(均P<0.05)。结论:自由体位配合硬膜外分娩镇痛可以降低初产妇分娩产程,减轻分娩疼痛感,提高阴道分娩率,缩短初次母乳喂养时间,产妇分娩控制感、舒适度及满意度更高,值得推荐。Objective:To explore the effects of the free position combined with epidural analgesia for labor analgesia of primiparaes on their second stage of labor,vaginal delivery rate and labor pain.Methods:The primiparaes treated in the hospital from January 2023 to June 2023 were selected in this study.These primiparaes were divided into two groups by different trial labor intervention programs.The primiparaes in the observation group received the free position combined with epidural labor analgesia,while the primiparaes in the control group received the conventional vaginal trial labor.After excluding the confounding factors of the baseline data of the primiparaes by propensity matching scoring,105 primiparae were selected in each of the two groups.The duration of labor,the degree of labor pain at the 2nd hour of the labor onset,at the full opening of the cervix and at the exposure of the fetal head,the rates of the different delivery mode,such as the vaginal delivery,the trail vaginal delivery turned to cesarean section and the vaginal delivery with the perineum lateral incision,the situation of the postpartum recovery evaluated by the postpartum 2h bleeding volume and the first breastfeeding time,the scores of the labour agentry scale(LAS),Edinburgh postnatal depressions scale(EPDS)and postpartum general comfort questionnaire(GCQ),and the maternal satisfaction of the primiparaes were compared between the two groups.Results:The time of the first,the second or the third stages of labor of the primiparaes in the observation group were significantly lower than those of the primiparaes in the control group.The total labor time(8.65±2.48h)of the primiparaes in the observation group was significantly lower than that(12.85±2.63h)of the primiparaes in the control group.The vaginal delivery rate(100.0%)of the primiparaes in the observation group was significantly higher than that(96.2%)of the primiparaes in the control group.The postpartum recovery situation of the primiparaes in the observation group was significantly bette

关 键 词：初产妇 硬膜外分娩镇痛 自由体位 第二产程 阴道分娩率 分娩疼痛感 分娩控制感 产后舒适状况 

分 类 号：R47[医药卫生—护理学]