应用助产路径降低产妇分娩疼痛及其机制研究
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摘要
目的探讨应用助产路径对产妇的分娩疼痛、乳酸浓度及分娩结局的影响及其机制研究。方法选取产房阴道试产的产妇200例,随机分为观察组和对照组各100例。对照组按照分娩期常规全程管理;观察组按照助产路径全程管理,比较两组分娩疼痛评分、产程中血浆乳酸值及分娩结局。结果观察组的PPI评分及乳酸值(宫口开全)均低于对照组(P<0.05);对照组宫口开全时乳酸值与PPI评分存在正相关关系(r=0.206,P<0.05);两组在总产程时间及产后出血量差异均有统计学意义(P<0.05)。结论应用助产路径可有效降低产妇的分娩疼痛,缩短产程,减少不良的分娩结局,促进母婴健康。
Objective To investigate the effect of the application of midwifery path on labor pain,lactic acid concentration and delivery outcome and the mechanism in parturients.Methods 200 cases in the delivery room were selected and randomly divided into the observation group and the control group,each of 100 cases.The control group was managed with the whole course of nursing.The observation group managed with the midwifery path model.The scores of labor pain,plasma lactate and the outcome of delivery were compared between the two groups.Results The observation group in the PPI score and lactate(full dilatation) were lower than the control group(P < 0.05); There was a positive correlation between the lactate of the full dilatation and the PPI score in the control group(r=0.206,P < 0.05).Two groups in the total labor time and the amount of postpartum hemorrhage all were significant difference(P < 0.05).Conclusion The application of midwifery path can effectively reduce the pain of parturition,shorten the duration of labor,reduce the bad delivery outcome and promote the health of mother and child.
Objective To investigate the effect of the application of midwifery path on labor pain,lactic acid concentration and delivery outcome and the mechanism in parturients.Methods 200 cases in the delivery room were selected and randomly divided into the observation group and the control group,each of 100 cases.The control group was managed with the whole course of nursing.The observation group managed with the midwifery path model.The scores of labor pain,plasma lactate and the outcome of delivery were compared between the two groups.Results The observation group in the PPI score and lactate(full dilatation) were lower than the control group(P < 0.05); There was a positive correlation between the lactate of the full dilatation and the PPI score in the control group(r=0.206,P < 0.05).Two groups in the total labor time and the amount of postpartum hemorrhage all were significant difference(P < 0.05).Conclusion The application of midwifery path can effectively reduce the pain of parturition,shorten the duration of labor,reduce the bad delivery outcome and promote the health of mother and child.
引文
[1]杨慧霞,李博雅.剖宫产后时代面临的挑战剖宫产术后再次妊娠阴道分娩相关问题[J].中华妇产科杂志,2016,51(8):573-575.
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[6]杨瑞蓉.循证护理与单纯全程陪产护理模式在产科分娩中的效果观察[J].实用临床医药杂志,2014,18(8):66-68.
[7]卞燕,江秀敏.陪伴分娩对初产妇分娩疼痛及分娩结局的影响研究[J].中国卫生标准管理,2017,8(10):132-134.
[8]王琼.分娩方式的差异对母婴围产期相关并发症的临床影响比较研究[J].中国医学创新,2013,10(28):115-116.
[9]袁文浩,曾凌空,蔡保欢,等.动脉血乳酸对于新生儿休克严重程度和预后判断的价值[J].中国当代儿科杂志,2018,20(1):17-20.
[10]陈景亮,杨智君,乔淼,等.新生儿脐带血血气分析对三种分娩方式的评价[J].中国医刊,2016,51(3):59-62.
[11]尚春华.脐血血气分析及乳酸测定对新生儿窒息的诊断意义[J].中国实用医药,2015,10(24):67-68.
[2]Yuhui Shi,Ying Jiang,Qingqi Zeng,et al.Influencing factors associated with the mode of birth among childbearing women in Hunan Province:a cross-sectional study in China[J].BMC Pregnancy and Childbirth,2016,16:108.
[3]Siamak A,Feizollah A,Aboulfath L,et al.Developing evidencebased maternity care in Iran:a quality improvement study[J].BMC Pregnancy and Childbirth,2008,8(1):20.
[4]Bick DE,Rycroft-Malone J,Fontenla M.A case study evaluation of implementa-tion of a care pathway to support normal birth in one English birth centre:anticipated benefits and unintended consequences[J].BMC Pregnancy and Childbirth,2009,9(1):47.
[5]胡海游.简化版的Mc Gill疼痛问卷表(SF-MPQ)在术后静脉自控镇痛的应用[D].长沙:中南大学湘雅二医院,2014:2.
[6]杨瑞蓉.循证护理与单纯全程陪产护理模式在产科分娩中的效果观察[J].实用临床医药杂志,2014,18(8):66-68.
[7]卞燕,江秀敏.陪伴分娩对初产妇分娩疼痛及分娩结局的影响研究[J].中国卫生标准管理,2017,8(10):132-134.
[8]王琼.分娩方式的差异对母婴围产期相关并发症的临床影响比较研究[J].中国医学创新,2013,10(28):115-116.
[9]袁文浩,曾凌空,蔡保欢,等.动脉血乳酸对于新生儿休克严重程度和预后判断的价值[J].中国当代儿科杂志,2018,20(1):17-20.
[10]陈景亮,杨智君,乔淼,等.新生儿脐带血血气分析对三种分娩方式的评价[J].中国医刊,2016,51(3):59-62.
[11]尚春华.脐血血气分析及乳酸测定对新生儿窒息的诊断意义[J].中国实用医药,2015,10(24):67-68.