摘要
目的 通过研究产妇及胎儿的临床结局,探讨腰硬膜外联合阻滞麻醉配合分娩体位护理指导的临床疗效。方法 选择2020年4月至2022年6月在福建省妇幼保健院(本院)分娩的226例产妇作为研究组,均为自愿要求进行镇痛分娩的单胎头位且无严重合并症及并发症的初产妇,另选择同期在本院分娩的未采取镇痛分娩措施的183例产妇作为对照组。研究组给予腰硬膜外联合阻滞麻醉以及根据产程进展和胎儿方位所采取的体位护理指导措施;对照组则采取常规舒适体位,直至宫口全开。比较两组镇痛效果、各产程时间、分娩方式、分娩结局及满意度。结果 研究组第一产程及总产程时间均明显短于对照组,差异有统计学意义(P <0.05)。研究组镇痛总有效率为100.00%,高于对照组的25.14%,差异有统计学意义(P <0.05)。研究组产妇顺产比例明显高于对照组,差异有统计学意义(P <0.05)。研究组产妇产后2 h出血量明显低于对照组,差异有统计学意义(P <0.05)。研究组新生儿并发症总发生率为0.88%,明显低于对照组的3.28%,差异有统计学意义(P <0.05)。研究组很满意占比高于对照组,差异有统计学意义(P <0.05)。结论产程中腰硬膜外联合阻滞麻醉镇痛分娩配合体位护理可显著改善产妇分娩时疼痛,有效促进子宫扩张,缩短产程,有利于胎儿顺利娩出,同时还可促进自然分娩,降低阴道助产率和剖宫产率,减少母婴并发症的发生。
Objective To observe the clinical effect of combined spinal-epidural block anesthesia with position nursing based on the labor progress and fetal position during labor.Methods A total of 226 primiparous women who gave birth at Fujian Maternity and Child Health Hospital(our hospital)from April 2020 to June 2022 were selected as the study group.They were all primiparous women with full-term singleton fetus with cephalic presentation who voluntarily requested analgesic delivery and had no serious concomitant symptoms or complications.In addition,183 primiparous women who gave birth at our hospital during the same period and did not take analgesic delivery measures were selected as the control group.The parturients in the study group were given combined spinal-epidural block anesthesia,and position nursing measures were taken based on the labor progress and fetal position;The parturients in the control group adopted a routine comfortable position until the cervix was fully opened.The labor process,delivery method,analgesic effect,2-hour postpartum bleeding volume,incidence of neonatal complications,and satisfaction between the two groups of parturients were compared.Results The first and total stages of labor in the study group were significantly shorter than those in the control group,with statistically significant differences(P<0.05).The total effective rate of analgesia in the study group was 100.00%,higher than 25.14%in the control group, with statistically significant difference (P < 0.05). The proportion of normal labor in the study group was significantly higher than that in the control group (P < 0.05). The 2-hour postpartum bleeding volume of parturients in the study group was significantly lower than that in the control group, with statistically significant difference (P < 0.05). The total incidence of neonatal complications in the study group was 0.88%, significantly lower than 3.28% in the control group, with statis tically significant difference (P < 0.05). The proportion of satisfaction in the research group was higher than that in the control group, with statistically significant difference (P < 0.05). Conclusion In the process of labor, combined spinal-epidural block anesthesia for analgesic delivery with position nursing can sig nificantly relieve the pain of the parturients during delivery, effectively promote uterine expansion, shorten the labor process, and help the smooth delivery of the fetus. At the same time, it can also promote natural childbirth, reduce the vaginal delivery rate and cesarean section rate, and reduce the incidence of maternal and infant c omplications.
作者
王武兰
郭胜斌
林传涛
陈禅娟
林雪凤
WANG Wulan;GUO Shengbin;LIN Chuantao;CHEN Chanjuan;LIN Xuefeng(Obstetrics Department,Fujian Maternity and Child Health Hospital,Fujian,Fuzhou 350001,China;College of Clinical Medicine for Obstetrics&Gynecology and Pediatrics,Fujian Medical University,Fujian,Fuzhou 350001,China;Anesthesia Department,Fujian Maternity and Child Health Hospital,Fujian,Fuzhou 350001,China)
出处
《中国医药科学》
2023年第24期117-121,共5页
China Medicine And Pharmacy
基金
福建省妇幼保健院护理科研专项基金资助计划(妇幼YCXH 22-03)。
关键词
分娩
镇痛
产程
体位护理
Delivery
Analgesia
Labor process
Position nursing
