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目的观察活跃期分娩镇痛配合全程导乐分娩对缩短经阴道分娩产程及减少产后并发症的临床效果,探讨提高分娩技术、减少母婴病率的方法。方法选取2010年1月—2012年6月在陕西省妇幼保健院产科生产的240例经阴道分娩产妇,将其随机分为观察组(120例)和对照组(120例)。其中观察组于分娩活跃期给予硬膜外镇痛,并由具有分娩经验的助产士进行一对一全程陪护,给予产妇心理、生理上的全面支持。对照组未给予镇痛措施,采取产科常规护理措施。结果观察组第一产程时长为(358.4±162.3)min,第二产程时长为(46.5±22.6)min,总产程时长为(412.4±189.7)min,均较对照组明显缩短,差异具有统计学意义(P<0.01)。同时,观察组产后平均出血量、产后尿潴留发生率均显著低于对照组,差异具有统计学意义(P<0.01);新生儿早吸吮成功率明显高于对照组,差异具有统计学意义(P<0.05)。结论活跃期分娩镇痛配合全程导乐分娩可显著缩短经阴道分娩产程,减轻产妇分娩痛苦,并有效减少产后并发症,有助于降低剖宫产率,值得临床推广。
Objective To observe the clinical effect of labor analgesia during active delivery and full delivery of childbirth on shortening the labor process of vaginal delivery and reducing postpartum complications, and to explore ways to improve delivery techniques and reduce the incidence of maternal and infant diseases. Methods Two hundred and forty cases of vaginal delivery in obstetrics and gynecology from January 2010 to June 2012 in Shaanxi Maternal and Child Health Hospital were randomly divided into observation group (120 cases) and control group (120 cases). The observation group was given epidural analgesia in the active part of labor and was accompanied by one-on-one midwives with midwifery experience, giving maternal psychological and physical comprehensive support. The control group did not give analgesic measures, take the routine obstetrical care. Results The duration of the first stage of labor in the observation group was (358.4 ± 162.3) min, the duration of the second stage of labor was (46.5 ± 22.6) min and the total length of labor was (412.4 ± 189.7) min, which were significantly shorter than those in the control group (P <0.01). At the same time, the average amount of postpartum hemorrhage and the incidence of postpartum urinary retention in the observation group were significantly lower than those in the control group (P <0.01). The success rate of early suckling in neonates was significantly higher than that in the control group P <0.05). Conclusions The active labor analgesia combined with full-time delivery can significantly shorten the vaginal delivery of labor, reduce the pain of childbirth and delivery, and effectively reduce the postpartum complications, contribute to reduce the rate of cesarean section, worthy of clinical promotion.