自由体位提高自然分娩率降低剖宫产临床有效性研究

贺瑞宁，柳青梅

[陕西省榆林市第四人民（星元）医院产科，陕西 榆林，719000]

浏览次数：85次 下载次数：317次

摘要：

目的 探究自由体位提高自然分娩率降低剖宫产临床有效性。方法 选取2014年10月至2016年10月于本院就诊及生产的80例产妇作为研究对象，随机分为试验组和对照组，每组各有40例。对照组产妇应用常规的卧位方式进行分娩，试验组产妇应用自由体位方式进行分娩，分析比较两组产妇的分娩方式、护理满意度、总产程时间及视觉模拟评分（VAS 评分）。结果 试验组产妇的自然分娩率为87.50%明显高于对照组的60.00%，试验组的剖宫产率（12.50%）明显低于对照组（40.00%） （P<0.05）；试验组产妇的护理满意度（97.50%）与对照组产妇（75.00%）比较，组间差异明显（P<0.05）；试验组产妇的总产程时间、VAS 评分分别为（7.13±1.06）h、（3.51±0.52）分，与对照组产妇的（10.87±1.24）h、（6.32±0.79）分相比，组间差异显著 （P<0.05）。结论 对产妇采取自由体位的方式进行分娩可明显提高自然分娩率，降低产妇的剖宫产率，加快产程，明显减轻分娩疼痛，值得进一步推广使用。

关键词：自由体位；自然分娩；剖宫产

中图分类号：R714.3文献标志码：A文章编号：2096-1413(2017)30-0131-02

Clinical effectiveness of free position in improving the natural delivery rate and reducing cesarean section
HE Rui-ning, LIU Qing-mei
[Department of Obstetrics, the Fourth People``s (Xingyuan) Hospital of Yulin, Yulin 719000, China]

ABSTRACT: Objective To study the clinical effectiveness of free position in improving the natural delivery rate and reducing cesarean section. Methods Eighty cases of puerpera admitted in our hospital from October 2014 to October 2016 were selected and randomly divided into experimental group and control group, with 40 cases in each group. The control group was treated with conventional supine method and the experimental group maternal was applied free body position for childbirth. The delivery mode, the nursing satisfaction, the total labor time and the visual analogue scale (VAS) were compared between the two groups. Results The rate of natural delivery of experimental group was 87.50% , which was higher than 60.00% of the control group; the rate of cesarean section (12.50%) was lower than that in the control group (40.00%) (P<0.05). There were significant differences in the care satisfaction between the experimental group (97.50%) and control group (75.00%) (P<0.05). The total labor time and VAS score of the experimental group maternal were (7.13±1.06) h, (3.51±0.52), which were better than (10.87±1.24) h, (6.32±0.79) h in the control group, there were significant differences between the two groups (P<0.05). Conclusion It is possible to improve the rate of natural childbirth, reduce the rate of cesarean section, shorten the labor time and relieve the pain obviously by taking the free body position, which is worthy of popularization and application.
KEYWORDS: free position; natural delivery; cesarean section

参考文献：
[1] BYRNE J,HAUCK Y,FISHER C,et al.Effectiveness of a mindfulness- based childbirth education pilot study on maternal self -efficacy and fear of childbirth[J].J Midwifery Womens Health,2014,59(2):192-197.
[2] ROUHE H,SALMELA-ARO K,TOIVANEN R,et al.Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience-a randomised controlled trial[J].J Psychosom Obstet Gynaecol,2015,36(1):1-9.
[3] 潘敏,雪丽霜,零恒莉,等.产程早期体位干预配合分娩辅助设施对分娩的影响[J].中华护理杂志,2014,49(3):297-300.
[4] BOGNER G,HAMMER BE,SCHAUSBERGER C,et al.Patient satisfaction with childbirth after external cephalic version [J].Arch Gynecol Obstet,2014,289(3):523-531.
[5] 黄奕,陈利敏,林意,等.自由体位分娩对自然分娩率和剖宫产率影响的临床观察[J].生殖医学杂志,2015,24(1):37-40.
[6] TULLY KP,BALL HL.Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth[J].Midwifery,2014,30 (6):712-719.
[7] 郑碧珠.初产妇采用导乐球配合自由体位促进自然分娩的体会[J]. 中外医学研究,2016,14(25):93-95.
[8] 金新丽.陪伴待产配合自由体位管理在初产妇自然分娩中的应用 [J].中华现代护理杂志,2014,20(30):3860-3862.
[9] HUTTPN EK,HALL W.Psychoeducation for pregnant women with fear of childbirth increases rates of spontaneous vaginal delivery, reduces caesarean rates and improves delivery experience [J].Evid Based Nurs,2014,17(4):105.
[10] 朱月球,张俊梅.自由体位分娩与人文关怀联合应用促进自然分娩的效果分析[J].临床医学工程,2016,23(10):1407-1408.