拉玛泽呼吸法配合无保护接产对产妇负性情绪及分娩结局的影响

目的 探讨拉玛泽呼吸法配合无保护接产技术对产妇负性情绪及分娩结局的影响,旨在为产科提高分娩质量和护理服务提供有效依据。 方法 将2015年1—12月在杭州市红十字会医院建卡产检、分娩的460例低危初产妇随机分为对照组和观察组各230例，对照组采用传统的保护会阴技术分娩；观察组孕28周起接受拉玛泽呼吸法学习且坚持每天练习直到临产并配合无保护会阴接产技术分娩；采取焦虑自评量表(SAS)和抑郁自评量表(SDS)评价2组初产妇负性情绪状况，观察并比较2组产妇的会阴裂伤、第二产程时间、产后出血量及新生儿窒息的发生情况。 结果 观察组初产妇分娩前12 h内SAS评分(33.20±9.53)分]及SDS评分(31.15±6.44)分]均低于对照组SAS评分(64.38±5.50)分]及SDS评分(61.89±5.09)分]，差异均有统计学意义(t=42.96、56.79；均P<0.001)；观察组会阴完整率为12.17%,Ⅱ度会阴裂伤发生率为25.65%(59/230),对照组会阴完整率为2.61%,Ⅱ度会阴裂伤发生率为39.13%(90/230),观察组会阴完整及Ⅱ度裂伤情况明显低于对照组(χ2=14.01、9.54；均P<0.05);观察组产后出血量(225.12±46.12) ml]低于对照组产后出血量(248.20±50.28) ml],差异有统计学意义(t=5.13,P<0.05)；观察组新生儿窒息4例(1.74%)，低于对照组的19例(8.26%)，差异有统计学意义(χ2=10.30,P<0.05)。 结论 采用拉玛泽呼吸法配合无保护会阴接产技术能改善初产妇负性情绪，减少会阴损伤，减少产后出血及新生儿窒息，促进自然分娩。 

Effect of Lamaze breathing method on negative emotion and delivery outcome of maternal

Objective To investigate the effect of lamaze breathing method with unprotected delivery technology on maternal negative emotions and birth outcomes,thus to provide effective reference to the improvement of the quality of delivery for obstetrics and high quality nursing service. Methods A total of 460 cases of low-risk primiparas who set up a cord of medical care and delivered in our hospital were randomly divided into control group and observation group with 230 cases in each group.While the control group received routine prenatal care and pregnancy education,using the technology of traditional protection of perineum childbirth,observation group voluntarily accepted lamaze breathing since the 28th weeks and insisted on learning practice every day until the parturient with unprotected perineum delivery technology.Self rating Anxiety Scale(SAS) and self rating Depression Scale(SDS) were used to compare between the two groups of primiparas' negative emotional status and observation of the two groups were made to compare the perineal laceration,the second stage of labor time,postpartum hemorrhage and neonatal weight asphyxia. Results The primiparas in observation group got (33.20±9.53) SAS score and (31.15±6.44) SDS score within 12 h before delivery which were lower than those in the control group,(64.38±5.50) SAS score and (61.89±5.09) SDS score respectively,with statistical significance(t=42.96,56.79,P<0.001).In the observation group,the perineal integrity rate was 12.17%,second degree perineal laceration incidence was 25.65%(59/23).In the control group perineal integrity rate was 2.61%,second degree perineal laceration incidence was 39.13%(90/230).The perineal integrity rate and second degree perineal complete laceration in the observation group was significantly lower than those in the control group(χ2=14.01,9.54,P<0.05).Postpartum hemorrhage amount in the observation group was (225.12±46.12)ml lower than that(248.20±50.28)ml in the control group,and the difference was statistically significant(t=5.13,P<0.05);The observation group had 4 cases of neonatal asphyxia(1.74%),less than that 19(8.26%) in the control group,and the difference was statistically significant(χ2=10.30,P<0.05). Conclusion The lamaze breathing method in the low-risk parturient with unprotected perineum delivery of primipara technique can improve negative emotions,reduce perineal injury,reduce postpartum hemorrhage and neonatal asphyxia,and promote natural childbirth.