无痛分娩配合自由体位待产对初产妇自我效能及分娩结局的影响

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摘要目的分析无痛分娩配合自由体位待产对初产妇自我效能及分娩结局的影响。方法选取2018年7月～2019年4月我院收治的200例初产妇作为研究对象，按照简单随机抽样的方法将其分为对照组（100例）和试验组（100例）。对照组产妇采用自然常规待产方法，试验组产妇采用无痛分娩配合自由体位待产方法。比较两组的产妇的剖宫产率、视觉模拟量表（VAS）评分、产后总出血量、住院时间、产程和新生儿Apgar 评分，并观察两组分娩后的盆底肌力、肌肉疲劳度、分娩结局及分娩前后的自我效能评分。结果试验组产妇的剖宫产率低于对照组，差异有统计学意义（P＜0.05）；试验组产妇的VAS评分低于对照组，产后总出血量少于对照组，住院时间短于对照组，差异有统计学意义（P<0.05）。试验组产妇的第一产程、第二产程、第三产程均短于对照组，差异有统计学意义（P＜0.05）；试验组新生儿出生1 min时的Apgar 评分高于对照组，差异有统计学意义（P＜0.05）。分娩前，两组产妇的自我效能评分比较，差异无统计学意义（P＞0.05）；分娩后，两组产妇的自我效能评分均高于本组分娩前，差异有统计学意义（P＜0.05）；分娩后，试验组产妇的正性态度、自我决策、自我减压评分均高于对照组，差异有统计学意义（P＜0.05）。试验组产妇分娩后的盆底肌力高于对照组，差异有统计学意义（P＜0.05）；试验组产妇Ⅰ、Ⅱ类纤维的肌肉疲劳度均低于对照组，差异有统计学意义（P＜0.05）。试验组的不良分娩结局总发生率（19.0%）低于对照组（37.0%），差异有统计学意义（P＜0.05）。结论初产妇应用无痛分娩技术配合自由体位进行生产，有助于保护女性盆底肌功能，缩短产程，并在一定程度上提高其自我效能，有利于产后心理、生理恢复。

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	黄静云
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关键词 ：无痛分娩, 自由体位, 初产妇, 自我效能, 产程, 盆底肌力

Abstract：Objective To analyze the effect of painless delivery combined with free position for labor on the self-efficacy and delivery outcomes of primiparas.Methods A total of 200 primiparas admitted to our hospital from July 2018 to April 2019 were selected as research objects.They were divided into the control group (100 cases) and the experimental group (100 cases) according to the simple random sampling method.The control group used the natural conventional method for labor, and the experimental group used the painless labor combined with free position method for labor.The cesarean section rate, visual analogue scale (VAS) score, total postpartum hemorrhage, length of hospital stay,labor process, and neonatal Apgar score between the two groups were compared.The pelvic floor muscle strength, muscle fatigue after delivery, delivery outcomes, and self-efficacy scores before and after delivery in the two groups were observed.Results The cesarean section rate in the experimental group was lower than that in the control group, and the difference was statistically significant (P＜0.05).The VAS score of the experimental group was lower than that of the control group, the total postpartum hemorrhage was less than that of the control group, and the length of hospital stay was shorter than that of the control group, the differences were statistically significant (P＜0.05).The first, second, and third stages of labor process in the experimental group were shorter than those in the control group, and the differences were statistically significant (P＜0.05).Apgar score at 1 minute of birth in the experimental group was higher than that in the control group, and the difference was statistically significant (P＜0.05).Before delivery, there were no significant differences in the self-efficacy scores between the two groups (P＞0.05).After delivery, the self-efficacy scores of the two groups were higher than those before delivery, and the differences were statistically significant (P＜0.05).After delivery, the positive attitude, self-determination, and self-decompression scores in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05).The pelvic floor muscle strength after delivery in the experimental group was higher than that in the control group, and the difference was statistically significant (P＜0.05).The muscle fatigue of Ⅰand Ⅱfibers in the experimental group was lower than that in the control group, and the difference was statistically significant (P＜0.05).The total incidence rate of adverse delivery outcomes in the experimental group (19.0%) was lower than that in the control group (37.0%), and the difference was statistically significant (P＜0.05).Conclusion Painless delivery combined with free position for labor in primiparas is helpful to protect the pelvic floor function, shorten the labor process, improve the self-efficacy to a certain extent,which is beneficial to postpartum psychological and physiological recovery.

Key words： Painless delivery Free position Primiparas Self-efficacy Labor Pelvic floor muscle strength

作者简介: 黄静云（1972-），女，广东梅州人，本科，副主任护师，主要研究方向：助产

引用本文:

黄静云; 张春秀; 张丽明; 洪敬丹. 无痛分娩配合自由体位待产对初产妇自我效能及分娩结局的影响[J]. 中国当代医药, 2020, 27(11): 102-106.
HUANG Jing-yun; ZHANG Chun-xiu; ZHANG Li-ming; HONG Jing-dan. Effect of painless delivery combined with free position for labor on the self-efficacy and delivery outcomes of primiparas. 中国当代医药, 2020, 27(11): 102-106.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I11/102

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