摘要
目的:探讨集束化护理在初产妇第一、二产程分娩镇痛中的应用及其实施效果,为分娩镇痛护理管理提供借鉴。方法:选取拟行经阴道分娩的初产妇926例,以入产房顺序随机分为观察组与对照组,每组463例。对照组予以分娩期常规护理,观察组在常规护理的基础上予以分娩镇痛的集束化护理,包括类"拉玛泽呼吸减痛分娩法"、神经肌肉放松运动、豆袋热敷镇痛、会阴弹性护理。比较两组的分娩方式、疼痛程度、产程时间及围产期母婴情况。结果:观察组自然分娩、经阴道分娩构成比均高于对照组,剖宫产构成比低于对照组(P<0.05)。观察组0、Ⅰ级疼痛构成比均高于对照组,而Ⅱ、Ⅲ级疼痛构成比均低于对照组(P<0.01)。观察组与对照组经阴道分娩产妇分别为424、380例,观察组第一、二、三及总产程时间均少于对照组(P<0.05)。观察组胎儿窘迫及新生儿窒息比例、产妇产后2 h出血量均低于对照组(P<0.01或<0.05),新生儿1 min Apgar评分高于对照组(P<0.05)。结论:集束化护理应用于初产妇第一、二产程的分娩镇痛取得了较好的干预效果,提高了产妇经阴道分娩率,降低了疼痛程度和并发症发生率,缩短了产程时间,且具有较高的安全性。
Objective：To explore the application and effect of cluster based care on labor analgesia during first and second stage of labor in primipara,and provide reference for labor analgesia.Method：A total of 926 primiparas planning to perform vaginal delivery were selected and divided into the observation group and the control group by entering delivery room randomly,463 cases in each group.Primiparas in the control group were given conventional care during delivery,and primiparas in the observation group were given cluster based care on labor analgesia based on conventional care,including analogous-Lamaze childbirth Law respiratory care,nerve and muscle relaxation exercise,hot bean bag analgesia,perineal elastic nursing.Final delivery mode,pain degree,duration of labor and perinatal situation of two groups were compared.Result：Proportion of natural childbirth,vaginal delivery of the observation group were both higher than those of the control group,and proportion of caesarean was lower than that of the control group（P〈0.05）. Proportion of grade 0 and Ⅰ on pain were both higher than those of the control group,and proportion of grade Ⅱ and Ⅲ were lower than those of the control group（P〈0.01）.424 and 380 cases of vaginal delivery in the observation group and the control group,and the first,second,third stage and total labor time were all lower than those of the control group（P〈0.05）.Proportion of fetal distress and neonatal asphyxia,maternal bleeding amount in 2 h after delivery of the observation group were all less than those of the control group（P〈0.01 or 0.05）,and Apgar in 1 min was higher than that of the control group（P〈0.05）.Conclusion：It has a better interventional effect on labor analgesia by cluster based care during first and second stage of labor in primipara,it improves vaginal delivery rate,reduces pain degree and complications incidence,shortens labor time also has a higher security.
出处
《中国医学创新》
CAS
2016年第24期86-90,共5页
Medical Innovation of China
