自由体位接产与仰卧位接产对母婴影响的对比观察

目的 在体位待产及体位用力成熟的基础上，通过对比观察自由体位接产与仰卧位接产对母婴的影响，以探讨更有效的接产方式。 方法 按照入院顺序，随机将初产妇300例分为自由体位接产组(实验组)、仰卧位接产组(对照组)各150例，对比观察2组第二产程、总产程时间、会阴裂伤程度、会阴侧切、疼痛程度、新生儿窒息、产后出血情况。应用SPSS 17.0统计软件进行分析，计量资料采用t检验，计数资料采用χ2检验。 结果 实验组第二产程[(38.9±18.6)min]较对照组[(58.6±23.7)min]明显缩短(t=6.54，P<0.05),2组总产程时间差异无统计学意义。对照组出现重度疼痛33例(22.0%)，而实验组无重度疼痛病例发生(U=-18.11，P<0.01)。实验组的会阴完整率为14.0%(21/150)，明显高于对照组的3.3%(5/150)，χ2=10.78，P<0.01。实验组的会阴侧切率为3.3%(5/150)，明显低于对照组的18.0%(27/150)，χ2=16.93，P<0.01。2组产妇产后出血率差异无统计学意义(χ2=0.11，P>0.05)。实验组新生儿窒息2例，占1.3%，对照组中新生儿窒息12例，占8.0%。实验组新生儿窒息率明显低于对照组(χ2=7.49，P<0.01)。 结论 自由体位接产能明显减轻产痛，降低会阴侧切率，减少会阴裂伤程度，降低新生儿窒息率，且不会增加产后出血率，值得临床推荐应用。 

Comparative study of the effect of the free body position and the supine position on the mother and infant

Objective To investigate an effective delivery way by comparing the influence of free position delivery and supine delivery on maternal and neonatal outcomes. Methods According to the order of admission,300 primiparas were randomly divided into experimental group(liberal position delivery) and control group(supine delivery),150 women for each group.The second stage of labor,the total stages of labor,perineal laceration rate,episiotomy rate,labor pain degree,neonatal asphyxia and postpartum hemorrhage were observed and compared.SPSS 17.0 software was used to analyze the data,the measurement data using t test,the count data using χ2 test. Results The time of the second stage of labor in experimental group[(38.9±18.6)min] was significantly shorter than that of the control group[(58.6±23.7)min],t=6.54,P<0.05,the total labor time of two groups was not significant difference.In the control group,33 cases suffered severe pain(22.0%),while this was not happened in experimental group(U=-18.11,P<0.01).The perineal integrity rate of experimental group(14.0%,21/150) was significantly higher than that of control group(3.3%,5/150).Episiotomy rate of experimental group of was 3.3%(5/150) while the rate of the control group was 18.0%(27/150),χ2=16.93,P<0.01.Postpartum hemorrhage rate of two groups was not significantly difference(χ2=0.11,P>0.05).Two cases of neonatal asphyxia were found in experimental group,accounted for 1.3% while 12 cases were found in the control group,accounted for 8.0%.The rate of neonatal asphyxia in the control group was significantly lower than the control group(P<0.01). Conclusion Labor in free position can effectively reduce the labor pain,the rate of perineal incision,the degree of perineal laceration,the rate of neonatal asphyxia,and not increase the rate of postpartum hemorrhage.It is worthy of clinical promotion and application.