全程硬膜外分娩镇痛联合护理支持对产妇的影响

目的观察全程硬膜外分娩镇痛联合护理支持对产妇的影响。方法 2014年10月至2015年3月,便利抽样法选择在嘉兴市妇幼保健院实施硬膜外镇痛分娩的产妇450例为研究对象。按随机数字表法将其分为A、B、C三组,每组150例。A组产妇行全程硬膜外分娩镇痛联合护理支持,包括语言交流、情感支持、拉玛泽呼吸、体位干预等;B组产妇行全程硬膜外分娩镇痛,其他按常规护理;C组产妇第二产程停用镇痛泵直至分娩结束,其他按常规护理。观察三组产妇第二产程时间、分娩结局、记录各时段[宫口开1.0 cm(T1)、宫口开3.0 cm(T2)、宫口开10.0 cm(T3)、胎儿娩出(T4)及产后会阴部损伤修复时(T5)]疼痛视觉模拟评分(visual analog scale,V.AS)。结果三组产妇在T1、T2和T3时段VAS评分的差异均无统计学意义(均P0.05);A、B组患者在T4、T5时段VAS评分明显低于c组,差异均有统计学意义(均P0.05)。A组和C组第二产程时间明显短于B组,差异均有统计学意义(均P0.01);A组自然分娩率高于B组和C组,差异均有统计学意义(均P0.01);A组和B组在产后对镇痛分娩的满意率明显高于C组,差异均有统计学意义(均P0.05)。结论全程分娩镇痛联合有效护理支持的镇痛模式,在不影响第二产程时间及分娩结局的基础上能促进自然分娩,对母婴是安全的。

Effect of Continuous Epidural Labor Analgesia Combined With Nursing Supports on Puerpera

Obj ective To observe the effect of continuous epidural labor analgesia combined with nursing supports on puerpera.Methods By convenience sampling,450 cases were selected and equally divided into A,B,C three groups. Group A received continuous epidural labor analgesia combined with nursing supports including verbal communication, emotional support,Lamaze breath,and posture intervention.Group B received only epidural labor analgesia and other routine nursing.Group C was not received epidural labor analgesia in second stage until end and other routine nursing supports.Time of second stage of labor,delivery outcome,and the visual analog scale (VAS )pain scores at 1 .0 cm (T1),3.0 cm (T2),10.0 cm cervical dilation(T3),delivery (T4)and perineal trauma repair (T5)were recorded.Results There was no statistical significance of VAS scores in T1,T2 and T3 among three groups (all P>0.05).The VAS score in T4 and T5 of group A and B were significantly lower than group C (P<0.05).The duration of second stage of labor in group A and C were significantly shorter than group B (all P<0.01).The nature birth rate in group A was higher than group B and group C (all P<0.01).The analgesic satisfaction rate in group A and B were significantly higher than group C (all P<0.05).Conclusions Continuous epidural labor analgesia combined with nursing supports can promote nature birth,which is safe for mother and child.