分娩镇痛产妇第二产程不同用力时机对分娩体验及母婴结局的影响  

Effects of Different Force Timing in the Second Stage of Labor on Delivery Experience and Maternal and Infant Outcomes in Parturient with Labor Analgesia

作　　者：吴巧贤[1] 梁曼 李永程[3] WU Qiaoxian;LIANG Man;LI Yongcheng(Department of Obstetrics,Dongguan Maternal and Child Health Hospital,Dongguan 523000,China;不详)

机构地区：[1]东莞市妇幼保健院产科,广东东莞523000 [2]东莞市妇幼保健院分娩中心,广东东莞523000 [3]东莞市妇幼保健院麻醉科,广东东莞523000

出　　处：《中国医学创新》2025年第9期54-59,共6页Medical Innovation of China

基　　金：2021年东莞市社会发展科技面上项目(一般项目)(20211800901032)。

摘　　要：目的:探究分娩镇痛产妇第二产程不同用力时机对分娩体验及母婴结局的影响。方法:选择东莞市妇幼保健院2022年1月—2023年6月收治的1000例分娩镇痛产妇,采用随机数字表法分为观察组(n=500)与对照组(n=500)。观察组采取延迟屏气用力(宫口开全1 h后指导产妇屏气用力),对照组采取即刻屏气用力(宫口开全时指导产妇屏气用力)。比较两组第二产程时间、用力屏气时间、母婴结局及分娩体验。结果:观察组第二产程时间、用力屏气时间均较对照组短,差异均有统计学意义(P<0.05);观察组剖宫产率、会阴裂伤率、产钳助产率、缩宫素应用率均较对照组低,差异均有统计学意义(P<0.05);与对照组相比,观察组产后2 h出血量少,差异有统计学意义(P<0.05);两组会阴侧切率比较,差异无统计学意义(P>0.05)。观察组1、5 min Apgar评分及动脉血氧分压(PaO_(2))、pH值、碱剩余(BE)均较对照组高,差异均有统计学意义(P<0.05);观察组中文版分娩体验量表(CEQ-C)各维度得分及总分均较对照组高,差异均有统计学意义(P<0.05)。结论:相较于即刻屏气用力,延迟屏气用力有利于缩短第二产程时间与用力屏气时间,降低剖宫产率、会阴裂伤率、产钳助产率、缩宫素应用率,减少产后2 h出血量,提升新生儿一般健康状况,使产妇获得更加理想的分娩体验。Objective:To explore the effects of different force timing in the second stage of labor on delivery experience and maternal and infant outcomes in parturient with labor analgesia.Method:A total of 1000 parturient with labor analgesia admitted to Dongguan Maternal and Child Health Hospital from January 2022 to June 2023 were selected and divided into observation group(n=500)and control group(n=500)by random number table method.The observation group took delayed breath holding force(guiding the parturient breath holding force after 1 h of cervix was fully opened),and the control group took immediate breath holding force(guiding the parturient breath holding force when the cervix was open).The second stage of labor time,forced breath holding time,maternal and infant outcomes and delivery experience were compared between the two groups.Result:The second stage of labor and forced breath holding time in observation group were shorter than those in control group,the differences were statistically significant(P<0.05).The cesarean section rate,perineal laceration rate,obstetric forceps delivery rate and oxytocin application rate in observation group were lower than those in control group,the differences were statistically significant(P<0.05).Compared with the control group,the blood loss 2 h after delivery in the observation group was less,the difference was statistically significant(P<0.05).There was no significant difference in lateral perineal resection rate between the two groups(P>0.05).Apgar scores at 1 and 5 min,arterial partial oxygen pressure(PaO2),pH value and base excess(BE)in observation group were higher than those in control group,the differences were statistically significant(P<0.05).The each dimension scores and total scores of Chinese experience questionnaire of childbirth(CEQ-C)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with immediate breath holding force,delayed breath holding force can shorten the secon

关 键 词：分娩镇痛 第二产程 用力时机 分娩体验 母婴结局 

分 类 号：R71[医药卫生—妇产科学]