中医穴位按摩联合分娩球在初产妇顺产镇痛中的应用效果分析
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摘要
目的分析中医穴位按摩联合分娩球在初产妇顺产镇痛中的应用效果,旨在为分娩镇痛提供参考。方法选择在辽宁中医药大学附属医院顺产的124例初产妇随机分为观察组和对照组各62例,对照组采用常规护理,观察组给予中医穴位按摩联合分娩球护理干预。分析两组产妇镇痛效果和干预前、后负性情绪,比较两组产妇产程时间和产后情况,对比两组产后不良反应及Apgar评分。结果对照组产妇镇痛总有效率为80.65%,观察组产妇镇痛总有效率为98.39%,两组差异有统计学意义(P<0.01)。干预前两组的负性情绪差异无统计学意义(P>0.05);干预后两组产妇的SDS评分和SAS评分均显著低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。对照组产妇的第一产程和第二产程时间均长于观察组产妇,差异有统计学意义(P<0.05)。观察组产妇产后2 h出血量显著少于对照组,产后第3天泌乳量显著多于对照组,差异均有统计学意义(P<0.05)。观察组产妇不良反应发生率3.22%显著低于对照组产妇的14.52%,新生儿Apgar评分高于对照组,两组差异均有统计学意义(P<0.05)。结论中医穴位按摩联合分娩球干预初产妇的镇痛效果显著提高,负性情绪改善,产程缩短,出血量减少,且产后不良反应发生率下降,值得在临床应用。
Objective To analyze the application effect of Chinese medicine acupoint massage combined with delivery ball in analgesia of spontaneous labor among primiparous women,provide a reference for labor analgesia.Methods A total of 124 primiparous women of spontaneous labor were selected from Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,then they were randomly divided into observation group and control group,62 primiparous women in each group.The primiparous women in control group were treated with routine nursing,and the primiparous women in observation group were treated with Chinese medicine acupoint massage combined with delivery ball.The analgesic effects and negative emotions before and after intervention in the two groups were analyzed.The duration of labor and postpartum situations in the two groups were compared.The adverse reactions after delivery and Apgar scores in the two groups were compared.Results The total effective rates of analgesia in control group and observation group were 80.65% and 98.39%,respectively,there was statistically significant difference between the two groups( P < 0.01).Before intervention,there was no statistically significant difference in negative emotions between the two groups( P>0.05).After intervention,SDS and SAS scores in the two groups were statistically significantly lower than those before intervention( P<0.05),SDS and SAS scores after intervention in observation group were statistically significantly lower than those in control group( P<0.05).The time of the first and the second stages of labor in control group was statistically significantly longer than that in observation group( P<0.05).The amount of blood loss within two hours after delivery in observation group was statistically significantly less than that in control group( P<0.05).The lactation volume on the third day after delivery in observation group was statistically significantly more than that in control group( P<0.05).The incidence rate of adverse reactions in observation group was 3.22%,which was statistically significantly lower than that in control group( 14.52%).Neonatal Apgar score in observation group was statistically significantly higher than that in control group( P<0.05).Conclusion The analgesic effect of Chinese medicine acupoint massage combined with delivery ball in spontaneous labor among primiparous women is significant,the negative emotions are improved,the stage of labor is shortened,the amount of blood loss and incidence rate of postoperative adverse reactions are reduced,the method is worthy of clinical application.
Objective To analyze the application effect of Chinese medicine acupoint massage combined with delivery ball in analgesia of spontaneous labor among primiparous women,provide a reference for labor analgesia.Methods A total of 124 primiparous women of spontaneous labor were selected from Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,then they were randomly divided into observation group and control group,62 primiparous women in each group.The primiparous women in control group were treated with routine nursing,and the primiparous women in observation group were treated with Chinese medicine acupoint massage combined with delivery ball.The analgesic effects and negative emotions before and after intervention in the two groups were analyzed.The duration of labor and postpartum situations in the two groups were compared.The adverse reactions after delivery and Apgar scores in the two groups were compared.Results The total effective rates of analgesia in control group and observation group were 80.65% and 98.39%,respectively,there was statistically significant difference between the two groups( P < 0.01).Before intervention,there was no statistically significant difference in negative emotions between the two groups( P>0.05).After intervention,SDS and SAS scores in the two groups were statistically significantly lower than those before intervention( P<0.05),SDS and SAS scores after intervention in observation group were statistically significantly lower than those in control group( P<0.05).The time of the first and the second stages of labor in control group was statistically significantly longer than that in observation group( P<0.05).The amount of blood loss within two hours after delivery in observation group was statistically significantly less than that in control group( P<0.05).The lactation volume on the third day after delivery in observation group was statistically significantly more than that in control group( P<0.05).The incidence rate of adverse reactions in observation group was 3.22%,which was statistically significantly lower than that in control group( 14.52%).Neonatal Apgar score in observation group was statistically significantly higher than that in control group( P<0.05).Conclusion The analgesic effect of Chinese medicine acupoint massage combined with delivery ball in spontaneous labor among primiparous women is significant,the negative emotions are improved,the stage of labor is shortened,the amount of blood loss and incidence rate of postoperative adverse reactions are reduced,the method is worthy of clinical application.
引文
[1]李爱红,陈世荣,黄碧红.拉玛泽减痛分娩法在基层医院初产妇的临床应用观察[J].中国妇幼保健,2013,28(21):3510-3512.
[2]郭路,冯玉华,叶朝.中医指压穴位法在产程中的应用[J].中华护理杂志,2016,51(4):438-442.
[3]邓松波,陆尧胜,方堃,等.生物反馈式经皮神经电刺激分娩镇痛系统的研制[J].生物医学工程学杂志,2015,32(3):650-655.
[4]刘晓晖,吴玲玲,易玮.穴位注射联合电针用于分娩镇痛临床研究[J].中国针灸,2015,35(11):1155-1158.
[5]刘嘉,邱迪,谭萱,等.经皮神经电刺激分娩镇痛的疗效观察[J].暨南大学学报(自然科学与医学版),2016,37(5):416-419.
[6]韩斌,徐铭军,白云波.全产程分娩镇痛与第一产程分娩镇痛对妊娠高血压综合征产妇产程的影响[J].临床麻醉学杂志,2017,33(2):109-112.
[7]顾春怡,丁焱,张铮,等.孕妇分娩计划的实施效果评价[J].中华护理杂志,2016,51(12):1461-1465.
[8]曹莉园,周盛萍,龚云辉,等.分娩镇痛对初产妇产程的影响[J].实用妇产科杂志,2017,33(4):286-291.
[9]李乾,高扬,胡艳平,等.复方麝香按摩凝胶的抗炎、镇痛作用的实验研究[J].时珍国医国药,2017,28(9):2097-2098.
[10]Luces Lago AM,Mosquera Pan L,Tizón Bouza E.The birthing ball:rediscovering a non pharmacological resource of great importance in the birth process[J].Rev Enferm,2014,37(3):36-42.
[11]曾华,温秀兰,张广兰,等.中草药植物精油联合产后乳房康抚按摩对产妇泌乳的影响[J].中国妇幼保健,2014,29(15):2337-2339.
[12]幸吉娟,熊晓明,覃廷华,等.椎管内阻滞分娩镇痛对分娩及盆底影响的探讨[J].中国妇幼保健,2014,29(17):2762-2764.
[13]杨丽,戴丽.分娩球在孕妇自我效能干预中的临床应用[J].中国实用妇科与产科杂志,2014,30(10):817-819.
[14]Gayeski ME,Brüggemann OM,Monticelli M,et al.Application of nonpharmacologic methods to relieve pain during labor:the point of view of primiparous women[J].Pain Manag Nurs,2015,16(3):273-284.
[15]张映辉,马剑芬,沈柏儒,等.3种分娩镇痛方式的效果比较[J].广东医学,2013,34(5):746-749.
[16]赵祉阳,荣艳霞,王燕.潜伏期硬膜外分娩镇痛对母婴影响的临床研究[J].中国妇幼保健,2014,29(5):702-704.
[17]厉跃红,吴娜,庄薇.分娩球配合自由体位助产对初产妇产痛、分娩控制感及妊娠结局的影响[J].中华护理杂志,2013,48(9):793-796.
[18]关正,刘琳,官彬,等.静脉输注右美托咪定联合规律性间断硬膜外注射分娩镇痛疗效分析[J].实用妇产科杂志,2016,32(3):225-228.
[19]付建英,刘迎军.分娩球纠正胎儿臀先露的临床观察[J].中国妇幼保健,2013,28(9):1529-1530.
[20]Chestnut DH.Labor epidural analgesia and breastfeeding[J].Anesthesiology,2017,127(4):593-595.
[21]刘大纯,罗梅,何倩倩,等.中医药特色疗法促进产妇产褥期康复的临床研究[J].重庆医学,2016,45(7):947-949.
[2]郭路,冯玉华,叶朝.中医指压穴位法在产程中的应用[J].中华护理杂志,2016,51(4):438-442.
[3]邓松波,陆尧胜,方堃,等.生物反馈式经皮神经电刺激分娩镇痛系统的研制[J].生物医学工程学杂志,2015,32(3):650-655.
[4]刘晓晖,吴玲玲,易玮.穴位注射联合电针用于分娩镇痛临床研究[J].中国针灸,2015,35(11):1155-1158.
[5]刘嘉,邱迪,谭萱,等.经皮神经电刺激分娩镇痛的疗效观察[J].暨南大学学报(自然科学与医学版),2016,37(5):416-419.
[6]韩斌,徐铭军,白云波.全产程分娩镇痛与第一产程分娩镇痛对妊娠高血压综合征产妇产程的影响[J].临床麻醉学杂志,2017,33(2):109-112.
[7]顾春怡,丁焱,张铮,等.孕妇分娩计划的实施效果评价[J].中华护理杂志,2016,51(12):1461-1465.
[8]曹莉园,周盛萍,龚云辉,等.分娩镇痛对初产妇产程的影响[J].实用妇产科杂志,2017,33(4):286-291.
[9]李乾,高扬,胡艳平,等.复方麝香按摩凝胶的抗炎、镇痛作用的实验研究[J].时珍国医国药,2017,28(9):2097-2098.
[10]Luces Lago AM,Mosquera Pan L,Tizón Bouza E.The birthing ball:rediscovering a non pharmacological resource of great importance in the birth process[J].Rev Enferm,2014,37(3):36-42.
[11]曾华,温秀兰,张广兰,等.中草药植物精油联合产后乳房康抚按摩对产妇泌乳的影响[J].中国妇幼保健,2014,29(15):2337-2339.
[12]幸吉娟,熊晓明,覃廷华,等.椎管内阻滞分娩镇痛对分娩及盆底影响的探讨[J].中国妇幼保健,2014,29(17):2762-2764.
[13]杨丽,戴丽.分娩球在孕妇自我效能干预中的临床应用[J].中国实用妇科与产科杂志,2014,30(10):817-819.
[14]Gayeski ME,Brüggemann OM,Monticelli M,et al.Application of nonpharmacologic methods to relieve pain during labor:the point of view of primiparous women[J].Pain Manag Nurs,2015,16(3):273-284.
[15]张映辉,马剑芬,沈柏儒,等.3种分娩镇痛方式的效果比较[J].广东医学,2013,34(5):746-749.
[16]赵祉阳,荣艳霞,王燕.潜伏期硬膜外分娩镇痛对母婴影响的临床研究[J].中国妇幼保健,2014,29(5):702-704.
[17]厉跃红,吴娜,庄薇.分娩球配合自由体位助产对初产妇产痛、分娩控制感及妊娠结局的影响[J].中华护理杂志,2013,48(9):793-796.
[18]关正,刘琳,官彬,等.静脉输注右美托咪定联合规律性间断硬膜外注射分娩镇痛疗效分析[J].实用妇产科杂志,2016,32(3):225-228.
[19]付建英,刘迎军.分娩球纠正胎儿臀先露的临床观察[J].中国妇幼保健,2013,28(9):1529-1530.
[20]Chestnut DH.Labor epidural analgesia and breastfeeding[J].Anesthesiology,2017,127(4):593-595.
[21]刘大纯,罗梅,何倩倩,等.中医药特色疗法促进产妇产褥期康复的临床研究[J].重庆医学,2016,45(7):947-949.