剖宫产与自然分娩产妇产后生活质量比较
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摘要
目的比较自然分娩与剖宫产分娩对产妇生活质量的影响,为改善产妇的生活质量提供依据。方法选择2017年1至12月在湖南省妇幼保健院产科分娩的124例孕妇为研究对象。按照分娩方式的不同,将其分别纳入自然分娩组(n=115)与剖宫产组(n=9),采用健康状况量表SF-36中文版对产妇产后6周的生活质量进行统计学分析。结果在SF-36量表的8个维度中,自然分娩组在生理功能(68.87±23.56vs.57.79±22.32)、生理职能(54.97±38.75vs.32.83±36.43)、总体健康(65.84±16.37vs.56.26±17.45)和社会功能(45.45±27.35vs.39.43±23.23)4个维度上得分均数均明显高于剖宫产组(t值分别为3.02、6.82、2.05、2.04,均P<0.05)。剖宫产组在精力(68.23±24.45vs.67.48±19.23)和精神健康(67.34±23.43vs.63.21±21.32)维度得分较自然分娩组高,但差异均无统计学意义(均P>0.05)。结论虽然剖宫产可以减少分娩疼痛和对于胎儿安全的焦虑,但是自然分娩对于孕妇产后生理机能恢复和心理健康都是更好的分娩方式,在产前教育中应更多地提倡自然分娩。
Objective To compare the effect of natural childbirth and cesarean section on the quality of life(QOL)of parturient,so as to provide some evidence for improving QOL.Methods A total of 124 pregnant women,who gave birth in Maternal and Child Health Hospital of Hunan Province from January to December 2017,were selected as study subjects and included in natural childbirth group(n=115)and cesarean section group(n=9)according to different delivery mode.The QOL of parturient at 6 weeks postpartum was statistically analyzed with the Chinese version of Short Form-36(SF-36).Results Among the 8 subscales of SF-36,the natural childbirth group had higher scores in physical functioning(68.87±23.56),role limitations due to physical problems(54.97±38.75),general health perception(65.84±16.37),and social functioning(45.45±27.35)than the caesarean section group(57.79±22.32,32.83±36.43,56.26±17.45,39.43±23.23)(t value was 3.02,6.82,2.05 and 2.04,respectively,all P<0.05).The mean scores of vitality(68.23±24.45)and mental health(67.34±23.43)in the cesarean section group were higher than those in the natural childbirth group(67.48±19.23,63.21±21.32).However,there was no statistical difference(both P>0.05).Conclusion Although cesarean section could reduce labor pain and fetal anxiety,natural childbirth is a better way for the recovery of postpartum physical functioning and mental health of pregnant women.Natural childbirth should be more advocated in prenatal education.
Objective To compare the effect of natural childbirth and cesarean section on the quality of life(QOL)of parturient,so as to provide some evidence for improving QOL.Methods A total of 124 pregnant women,who gave birth in Maternal and Child Health Hospital of Hunan Province from January to December 2017,were selected as study subjects and included in natural childbirth group(n=115)and cesarean section group(n=9)according to different delivery mode.The QOL of parturient at 6 weeks postpartum was statistically analyzed with the Chinese version of Short Form-36(SF-36).Results Among the 8 subscales of SF-36,the natural childbirth group had higher scores in physical functioning(68.87±23.56),role limitations due to physical problems(54.97±38.75),general health perception(65.84±16.37),and social functioning(45.45±27.35)than the caesarean section group(57.79±22.32,32.83±36.43,56.26±17.45,39.43±23.23)(t value was 3.02,6.82,2.05 and 2.04,respectively,all P<0.05).The mean scores of vitality(68.23±24.45)and mental health(67.34±23.43)in the cesarean section group were higher than those in the natural childbirth group(67.48±19.23,63.21±21.32).However,there was no statistical difference(both P>0.05).Conclusion Although cesarean section could reduce labor pain and fetal anxiety,natural childbirth is a better way for the recovery of postpartum physical functioning and mental health of pregnant women.Natural childbirth should be more advocated in prenatal education.
引文
[1]高丽琴.自然分娩和剖宫产对产妇的影响比较[J].临床医学研究与实践,2016,1(11):99-100.
[2]宁儒凤.剖宫产与自然分娩对早产儿血气、电解质等的影响[J].中国妇幼健康研究,2017,28(09):1109-1111.
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[4]何燕,赵龙超,刘丹萍,等.SF-36和SF-12在人群生命质量调查中的性能比较研究[J].现代预防医学,2017,44(05):852-862.
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[6]肖文霞,王会芝,周广杰,等.2014-2016年剖宫产率及剖宫产指征分析[J].医学理论与实践,2018,(19):2932-2934.
[7]刘兴会,代莉.我国自然分娩现状及展望[J].中国实用妇科与产科杂志,2015,31(02):97-100.
[8]Kavosi Z,Keshtkaran A,Setoodehzadeh F,et al.Acomparison of mothers'quality of life after normal vaginal,cesarean,and water birth deliveries[J].International journal of community based nursing and midwifery,2015,3(3):198.
[9]Kohler S,Sidney A K,Diwan V,et al.Postpartum quality of life in Indian women after vaginal birth and cesarean section:a pilot study using the EQ-5D-5L descriptive system[J].BMC Pregnancy Childbirth,2018,18(1):427.
[10]Kokabi R,Yazdanpanah D.Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women:A prospective cohort study[J].J Chin Med Assoc,2017,80(8):498-502.
[11]Chan A,Lew C,Wang X J,et al.Psychometric properties and measurement equivalence of the Multidimensional Fatigue Syndrome Inventory-Short Form(MFSI-SF)amongst breast cancer and lymphoma patients in Singapore[J].Health Qual Life Outcomes,2018,16(1):20.
[12]Treanor C,Donnelly M.A methodological review of the Short Form Health Survey 36(SF-36)and its derivatives among breast cancer survivors[J].Qual Life Res,2015,23(2):339-362.
[13]Awdeh H,Kassak K,Sfeir P,et al.The SF-36 and 6-minute walk test are significant predictors of complications after major surgery[J].World Journal of Surgery,2015,24(6):1406-1412.
[14]Hutton E K,Hannah M E,Ross S,et al.Maternal outcomes at 3 months after planned caesarean section versus planned vaginal birth for twin pregnancies in the Twin Birth Study:a randomised controlled trial:Counselling is difficult when outcomes are associated with mode of delivery and not the plan of mode of delivery[J].BJOG,2016,(4):644.
[15]Richez B,Ouchchane L,Guttmann A,et al.The role of psychological factors in persistent pain after cesarean delivery[J].J Pain,2015,(11):1136-1146.
[2]宁儒凤.剖宫产与自然分娩对早产儿血气、电解质等的影响[J].中国妇幼健康研究,2017,28(09):1109-1111.
[3]黄奎,袁飞飞,王红,等.SF-36量表用于中国大学生生活质量评价的信度与效度分析[J].安徽医药,2017,21(11):2002-2005.
[4]何燕,赵龙超,刘丹萍,等.SF-36和SF-12在人群生命质量调查中的性能比较研究[J].现代预防医学,2017,44(05):852-862.
[5]陈冰,高玉萍.近5年剖宫产指征及剖宫产率的变化分析[J].中国妇幼健康研究,2016,27(08):910-913.
[6]肖文霞,王会芝,周广杰,等.2014-2016年剖宫产率及剖宫产指征分析[J].医学理论与实践,2018,(19):2932-2934.
[7]刘兴会,代莉.我国自然分娩现状及展望[J].中国实用妇科与产科杂志,2015,31(02):97-100.
[8]Kavosi Z,Keshtkaran A,Setoodehzadeh F,et al.Acomparison of mothers'quality of life after normal vaginal,cesarean,and water birth deliveries[J].International journal of community based nursing and midwifery,2015,3(3):198.
[9]Kohler S,Sidney A K,Diwan V,et al.Postpartum quality of life in Indian women after vaginal birth and cesarean section:a pilot study using the EQ-5D-5L descriptive system[J].BMC Pregnancy Childbirth,2018,18(1):427.
[10]Kokabi R,Yazdanpanah D.Effects of delivery mode and sociodemographic factors on postpartum stress urinary incontinency in primipara women:A prospective cohort study[J].J Chin Med Assoc,2017,80(8):498-502.
[11]Chan A,Lew C,Wang X J,et al.Psychometric properties and measurement equivalence of the Multidimensional Fatigue Syndrome Inventory-Short Form(MFSI-SF)amongst breast cancer and lymphoma patients in Singapore[J].Health Qual Life Outcomes,2018,16(1):20.
[12]Treanor C,Donnelly M.A methodological review of the Short Form Health Survey 36(SF-36)and its derivatives among breast cancer survivors[J].Qual Life Res,2015,23(2):339-362.
[13]Awdeh H,Kassak K,Sfeir P,et al.The SF-36 and 6-minute walk test are significant predictors of complications after major surgery[J].World Journal of Surgery,2015,24(6):1406-1412.
[14]Hutton E K,Hannah M E,Ross S,et al.Maternal outcomes at 3 months after planned caesarean section versus planned vaginal birth for twin pregnancies in the Twin Birth Study:a randomised controlled trial:Counselling is difficult when outcomes are associated with mode of delivery and not the plan of mode of delivery[J].BJOG,2016,(4):644.
[15]Richez B,Ouchchane L,Guttmann A,et al.The role of psychological factors in persistent pain after cesarean delivery[J].J Pain,2015,(11):1136-1146.