催产素引产过程中联合体位管理对产程进展和分娩结局的影响
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摘要
目的:探讨催产素引产过程中联合体位管理对产程进展和分娩结局的影响。方法:选择2017年1-12月本院产科住院期间符合催产素引产指征的产妇150例作为研究对象,按照随机数字表法分为观察组和对照组,各75例。对照组产妇给予静脉滴注催产素引产,观察组产妇静脉滴注催产素引产的同时辅以体位管理。观察两组产程进展、产后2 h出血情况、产痛程度、分娩方式及分娩结局。结果:观察组产妇第一产程、第二产程及第三产程时间均较对照组产妇短,差异均有统计学意义(P<0.05);观察组产后2 h出血量较对照组少,差异有统计学意义(P<0.05);观察组产妇顺产率为89.33%明显高于对照组的45.33%,而剖宫产率为8.00%显著低于对照组的48.00%,差异均有统计学意义(P<0.05);观察组新生儿窒息、胎儿窘迫的发生率均较对照组低,而新生儿Apgar评分较对照组高,同时观察组产妇会阴Ⅱ度以上裂伤及产后尿潴留的发生率均较对照组低,差异均有统计学意义(P<0.05);观察组产妇VAS、VRS及PPI评分均较对照组低,差异均有统计学意义(P<0.05)。结论:催产素引产过程中辅以体位管理有助于缩短分娩产程,减少产后出血量,同时降低剖宫产率和降低产痛程度,并改善分娩结局。
Objective:To explore the influence on labor progress and delivery outcome of position management during induction of labor by Oxytocin.Method:From January to December 2017,150 parturients who met the indications of oxytocin induced labor in our hospital were selected as the study subjects.They were randomly divided into observation group and control group,75 cases in each group.The control group was given intravenous injection of Oxytocin to induce labor,while the observation group was given intravenous injection of Oxytocin to induce labor with postural management.The progress of labor,postpartum hemorrhage of 2 h,the degree of labor pain,the mode of delivery and the outcome of labor were observed in two groups.Result:The first stage of labor,the second stage of labor and the third stage of labor in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of neonatal asphyxia and fetal distress in the observation group were lower than those in the control group,and the Apgar score was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of laceration above grade Ⅱ of perineum and postpartum urinary retention in the observation group were lower than those in the control group(P<0.05).The VAS,VRS and PPI scores of the observation group were lower than those of the control group(P<0.05).Conclusion:Oxytocin assisted with postural management during induction of labor can shorten the delivery process,reduce postpartum hemorrhage,cesarean section rate and labor pain,and improve the delivery outcome.
Objective:To explore the influence on labor progress and delivery outcome of position management during induction of labor by Oxytocin.Method:From January to December 2017,150 parturients who met the indications of oxytocin induced labor in our hospital were selected as the study subjects.They were randomly divided into observation group and control group,75 cases in each group.The control group was given intravenous injection of Oxytocin to induce labor,while the observation group was given intravenous injection of Oxytocin to induce labor with postural management.The progress of labor,postpartum hemorrhage of 2 h,the degree of labor pain,the mode of delivery and the outcome of labor were observed in two groups.Result:The first stage of labor,the second stage of labor and the third stage of labor in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of neonatal asphyxia and fetal distress in the observation group were lower than those in the control group,and the Apgar score was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of laceration above grade Ⅱ of perineum and postpartum urinary retention in the observation group were lower than those in the control group(P<0.05).The VAS,VRS and PPI scores of the observation group were lower than those of the control group(P<0.05).Conclusion:Oxytocin assisted with postural management during induction of labor can shorten the delivery process,reduce postpartum hemorrhage,cesarean section rate and labor pain,and improve the delivery outcome.
引文
[1]田帅,田硕,王博强,等.催产素在神经系统内作用及机制的新进展[J].神经解剖学杂志,2018,34(1):117-121.
[2]郑志华,潘延恒.对113例产妇因阴道试产失败转为剖宫产的临床效果分析[J].当代医药论丛,2014,12(2):73.
[3]张依妮.不同分娩体位在第二产程应用的研究进展[J].中华护理杂志,2013,48(3):281-283.
[4]Gravina F S,van Helden D F,Kerr K P,et al.Phasic contractions of the mouse vagina and cervix at different phases of the estrus cycle and during late pregnancy[J].PLoS One,2014,9(10):e111307.
[5]王士钥.水囊联合小剂量催产素足月引产疗效观察[J].中国现代药物应用,2016,10(20):163-164.
[6]颜华英,孙香玲.孕妇生产过程中坐位体位指导的应用效果研究[J].中国现代医生,2015,53(6):125-128.
[7]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.
[8]周倩.改变产妇体位应用于临床矫正枕后位胎位不正的效果评价[J].中国妇幼保健,2014,29(9):1456-1458.
[9]曹红旭.不同分娩体位对产妇及新生儿的影响分析[J/OL].中国医学前沿杂志(电子版),2014,6(7):64-66.
[10]邹虹霞.使用侧俯卧位矫正枕后位和枕横位转至枕前位的临床分析[J].中外医学研究,2014,12(12):123-124.
[11]李君,冯艺,韩济生,等.中文版简版McGill疼痛问卷-2的制定与多中心验证[J].中国疼痛医学杂志,2013,19(1):42-46.
[12]刘香兰.分娩球配合自由体位助产对孕产妇心理状态、产痛及分娩控制感的作用[J].国际护理学杂志,2014,33(8):1935-1937.
[13]覃小珍,黄秋红,曾兰平,等.催产素静脉滴注应用于引产的效果观察[J].世界最新医学信息文摘,2017,17(35):129-130.
[14]金颖.缩宫素静脉滴注给药实施孕足月胎膜早破引产的效果分析[J].云南医药,2016,37(2):230-232.
[15]张丽萍.产程中体位改变对纠正胎位的影响与作用[J].基层医学论坛,2015,19(14):1885-1886.
[16]张宏玉.正常分娩定义与产程研究进展[J].中国生育健康杂志,2014,25(2):189-192.
[17]彭丽.一对一全程陪伴分娩与自由体位联合应用对第一产程的影响[J].中国医药指南,2014,12(3):75-76.
[18]Li T L,Kvist L J,Christensson K,et al.Striving for scientific stringency:a re-analysis of a randomised controlled trial considering first-time mothers’obstetric outcomes in relation to birth position[J].Bmc Pregnancy&Childbirth,2012,12(1):135-135.
[19]陈雅颂,袁力,钟沅月.新产程标准对瘢痕子宫孕妇再次阴道分娩结局的影响[J].广东医学,2017,16(22):3473-3474.
[20]杨湘妹,邱嵘,刘茜,等.助产士主导分娩疼痛管理对分娩结局及疼痛控制满意度的影响[J].重庆医学,2017,46(10):1333-1335.
[2]郑志华,潘延恒.对113例产妇因阴道试产失败转为剖宫产的临床效果分析[J].当代医药论丛,2014,12(2):73.
[3]张依妮.不同分娩体位在第二产程应用的研究进展[J].中华护理杂志,2013,48(3):281-283.
[4]Gravina F S,van Helden D F,Kerr K P,et al.Phasic contractions of the mouse vagina and cervix at different phases of the estrus cycle and during late pregnancy[J].PLoS One,2014,9(10):e111307.
[5]王士钥.水囊联合小剂量催产素足月引产疗效观察[J].中国现代药物应用,2016,10(20):163-164.
[6]颜华英,孙香玲.孕妇生产过程中坐位体位指导的应用效果研究[J].中国现代医生,2015,53(6):125-128.
[7]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.
[8]周倩.改变产妇体位应用于临床矫正枕后位胎位不正的效果评价[J].中国妇幼保健,2014,29(9):1456-1458.
[9]曹红旭.不同分娩体位对产妇及新生儿的影响分析[J/OL].中国医学前沿杂志(电子版),2014,6(7):64-66.
[10]邹虹霞.使用侧俯卧位矫正枕后位和枕横位转至枕前位的临床分析[J].中外医学研究,2014,12(12):123-124.
[11]李君,冯艺,韩济生,等.中文版简版McGill疼痛问卷-2的制定与多中心验证[J].中国疼痛医学杂志,2013,19(1):42-46.
[12]刘香兰.分娩球配合自由体位助产对孕产妇心理状态、产痛及分娩控制感的作用[J].国际护理学杂志,2014,33(8):1935-1937.
[13]覃小珍,黄秋红,曾兰平,等.催产素静脉滴注应用于引产的效果观察[J].世界最新医学信息文摘,2017,17(35):129-130.
[14]金颖.缩宫素静脉滴注给药实施孕足月胎膜早破引产的效果分析[J].云南医药,2016,37(2):230-232.
[15]张丽萍.产程中体位改变对纠正胎位的影响与作用[J].基层医学论坛,2015,19(14):1885-1886.
[16]张宏玉.正常分娩定义与产程研究进展[J].中国生育健康杂志,2014,25(2):189-192.
[17]彭丽.一对一全程陪伴分娩与自由体位联合应用对第一产程的影响[J].中国医药指南,2014,12(3):75-76.
[18]Li T L,Kvist L J,Christensson K,et al.Striving for scientific stringency:a re-analysis of a randomised controlled trial considering first-time mothers’obstetric outcomes in relation to birth position[J].Bmc Pregnancy&Childbirth,2012,12(1):135-135.
[19]陈雅颂,袁力,钟沅月.新产程标准对瘢痕子宫孕妇再次阴道分娩结局的影响[J].广东医学,2017,16(22):3473-3474.
[20]杨湘妹,邱嵘,刘茜,等.助产士主导分娩疼痛管理对分娩结局及疼痛控制满意度的影响[J].重庆医学,2017,46(10):1333-1335.
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