中医穴位按摩联合导乐分娩对初产妇负性情绪、乳房胀痛及分娩结局的影响
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摘要
目的探讨中医穴位按摩联合导乐分娩对初产妇负性情绪、乳房胀痛及分娩结局的影响。方法选取2017年1月至2018年2月本院收治的初产妇173例作为研究对象,按随机抽样的原则分为对照组86例(给予常规分娩护理)与联合组87例(在对照组基础上给予中医穴位按摩联合导乐分娩)。对两组初产妇均进行为期2周的跟踪随访,记录并比较两组初产妇负性情绪评分、乳房胀痛程度评级情况、分娩情况以及妊娠结局。结果护理后联合组SAS评分、SDS评分均明显低于对照组(P<0.05);联合组乳房胀痛程度明显轻于对照组(P<0.05);联合组初产妇剖宫产率、潜伏期VAS评分以及活跃期VAS评分均明显低于对照组,第一产程时间、第二产程时间以及产后出血量均明显少于对照组(P<0.05);联合组新生儿1min Apgar评分略高于对照组(P>0.05);联合组初产妇胎儿窒息、产褥感染、产后出血以及早产发生率均明显低于对照组(P<0.05)。结论通过对初产妇分娩过程中给予中医穴位按摩联合导乐分娩可明显改善负性情绪,减轻乳房胀痛程度,有利于产程进展及减少产后出血量,提高自然分娩率,可有效保障母婴安全。
Objective To discuss the effects of traditional Chinese medicine acupoint massage combined with doula delivery on negative emotion, breast distending pain and delivery outcome of primipara. Methods A total of 173 cases of primiparas in our hospital were selected as the research subjects from January 2017 to February 2018, according to the principle of random sampling, with 86 cases in the control group(given routine childbirth nursing) and 87 cases in the combined group(given traditional Chinese medicine acupoint massage combined with doula delivery on the basis of the control group). The two groups of primipara were followed up for 2 weeks. The negative emotion scores, breast distending pain rating, delivery condition and pregnancy outcomes of the primipara were recorded and compared between the 2 groups. Results After nursing, the self-rating anxiety scale(SAS) score, self-rating depression scale(SDS) score in the combined group were significantly lower than those in the control group(P <0.05). The breast distending pain in the combined group was significantly less than that in the control group(P <0.05). The cesarean section rate, latent VAS score and active VAS score in the combined group primiparas were significantly lower than those in the control group, and the time of the first stage of labor, the second stage of labor and the amount of postpartum hemorrhage in the combined group were significantly shorter than those in the control group(P <0.05); the l min Apgar score in the combined group was slightly higher than those in the control group(P>0.05). The incidence of fetal asphyxia, puerperal infection,postpartum hemorrhage and the premature delivery in the combined group were significantly lower than those in the control group(P <0.05). Conclusion By giving primipara traditional Chinese medicine acupoint massage combined with doula delivery, it can significantly improve negative emotions, reduce the breast distending pain, facilitate the progress of labor and reduce the amount of postpartum hemorrhage, improve the rate of natural delivery, and effectively guarantee the safety of mother and infant.
Objective To discuss the effects of traditional Chinese medicine acupoint massage combined with doula delivery on negative emotion, breast distending pain and delivery outcome of primipara. Methods A total of 173 cases of primiparas in our hospital were selected as the research subjects from January 2017 to February 2018, according to the principle of random sampling, with 86 cases in the control group(given routine childbirth nursing) and 87 cases in the combined group(given traditional Chinese medicine acupoint massage combined with doula delivery on the basis of the control group). The two groups of primipara were followed up for 2 weeks. The negative emotion scores, breast distending pain rating, delivery condition and pregnancy outcomes of the primipara were recorded and compared between the 2 groups. Results After nursing, the self-rating anxiety scale(SAS) score, self-rating depression scale(SDS) score in the combined group were significantly lower than those in the control group(P <0.05). The breast distending pain in the combined group was significantly less than that in the control group(P <0.05). The cesarean section rate, latent VAS score and active VAS score in the combined group primiparas were significantly lower than those in the control group, and the time of the first stage of labor, the second stage of labor and the amount of postpartum hemorrhage in the combined group were significantly shorter than those in the control group(P <0.05); the l min Apgar score in the combined group was slightly higher than those in the control group(P>0.05). The incidence of fetal asphyxia, puerperal infection,postpartum hemorrhage and the premature delivery in the combined group were significantly lower than those in the control group(P <0.05). Conclusion By giving primipara traditional Chinese medicine acupoint massage combined with doula delivery, it can significantly improve negative emotions, reduce the breast distending pain, facilitate the progress of labor and reduce the amount of postpartum hemorrhage, improve the rate of natural delivery, and effectively guarantee the safety of mother and infant.
引文
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[16]谢雯,陈敏,谭继权.长沙地区围产期孕妇B族链球菌带菌状况分析及对妊娠结局的影响[J].湖南中医药大学学报,2018,38(5):590-592.
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[18]杨洪萍.穴位按摩联合导乐分娩对初产妇心理状态、分娩情况及母婴结局的影响[J].长春中医药大学学报,2017,33(1):108-111.
[19]莫卫荣.穴位按摩对产褥期产妇负性情绪及乳房胀痛的改善作用[J].中西医结合护理(中英文),2017,3(5):80-82.
[20]黎静,胡海燕,钟梅.穴位按摩法对产妇产程影响及镇痛作用的研究[J].妇产与遗传(电子版),2016,6(4):46-51.
[2]SUNG J H,KIM S H,KIM Y M,et al.Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery[J].Journal of Perinatal Medicine,2016,44(8):903-911.
[3]聂芹.产后穴位按摩对产妇乳房胀痛及生活质量影响[J].辽宁中医药大学学报,2015,17(9):188-190.
[4]王朋.改良拉玛泽减痛联合穴位按摩对初产妇自然分娩结局影响[J].中国继续医学教育,2017,36(9):106-107.
[5]SHAMSHIRSAZ A A,RAVANGARD S F,OZHAND A,et al.Short-term neonatal outcomes in diamnio-tictwin pregnancies delivered after 32 weeks and indications of late preterm deliveries[J].American Journal of Perinatology,2014,31(5):365-372.
[6]MCCARTHY O L,WAZWAZ O,JADO I,et al.An intervention delivered by text message to increase the acceptability of effective contraception among young women in Palestine:study protocol for a randomised controlled trial[J].Trials,2017,18(1):454-457.
[7]刘晓艳.全程导乐陪伴分娩联合硬膜外镇痛在自然分娩中的应用价值[J].中国医学创新,2014,11(2):127-129.
[8]OWA T,MIMURA K,KAKIGANO A,et al.Pregnancy outcomes in women with different doses of corticosteroid supplementation during labor and delivery[J].Journal of Obstetrics and Gynaecology Research,2017,43(7):1132-1138.
[9]OMIH E E,LINDOW S.Impact of maternal age on delivery outcomes following spontaneous labour at term[J].Journal of Perinatal Medicine,2016,44(7):773-777.
[10]李旭霞,赵新翠.护理干预对预防未足月胎膜早破发生尿潴留的影响[J].湖南中医药大学学报,2014,34(2):43.
[11]MACHAREY G,V魧IS魧NENTOMMISKA M,GISSLER M,et al.Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation:a nationwide,population-based record linkage study[J].Journal of Perinatal Medicine,2017,46(3),2016,6(4):323-331.
[12]冯媛媛,罗敏然,蒋秋燕,等.电针对产妇DYN水平影响及分娩镇痛的临床疗效观察[J].右江民族医学院学报,2014,36(3):326-328.
[13]张慧,胡引,周菲菲,等.以肝胃经为主穴按摩对产后泌乳Ⅱ期的影响[J].中华护理杂志,2015,50(9):1043-1046.
[14]王爱英.第一产程综合干预促进产程进展的临床观察[J].湖南中医药大学学报,2013,33(10):42,50.
[15]张雯瑶.全程人性化导乐分娩模式对产妇产程及妊娠结局的影响[J].检验医学与临床,2016,13(11):1492-1493,1496.
[16]谢雯,陈敏,谭继权.长沙地区围产期孕妇B族链球菌带菌状况分析及对妊娠结局的影响[J].湖南中医药大学学报,2018,38(5):590-592.
[17]雷玉妃,黄志锋,黄凤.香薰疗法配合穴位按摩在阴道分娩中的应用研究[J].中国医学创新,2014,11(33):82-84.
[18]杨洪萍.穴位按摩联合导乐分娩对初产妇心理状态、分娩情况及母婴结局的影响[J].长春中医药大学学报,2017,33(1):108-111.
[19]莫卫荣.穴位按摩对产褥期产妇负性情绪及乳房胀痛的改善作用[J].中西医结合护理(中英文),2017,3(5):80-82.
[20]黎静,胡海燕,钟梅.穴位按摩法对产妇产程影响及镇痛作用的研究[J].妇产与遗传(电子版),2016,6(4):46-51.