非药物分娩镇痛仪联合导乐陪伴分娩促进自然分娩的临床研究

目的:探讨应用非药物分娩镇痛仪(导乐仪))联合导乐陪伴对分娩方式和分娩结局的影响。方法:将2014年8月～2015年8月在哈尔滨医科大学附属四院产科住院传统方式分娩的450例产妇设为对照组,2016年9月～2017年9月应用导乐仪联合导乐陪伴分娩的500例产妇设为观察组,比较两组产妇分娩活跃期的疼痛评分、分娩方式、产程时间、产后出血情况、新生儿窒息率、产后初乳分泌时间、纯母乳喂养率及产后抑郁的发生情况。结果:与对照组相比,观察组产妇中重度疼痛比例明显低于对照组(P0.01),剖宫产率明显降低,总产程明显缩短,经阴分娩率显著升高(P0.01)。观察组产妇产后出血量112.3±38.6 m L,明显低于对照组(152.7±80.5 m L,P0.05)。观察组新生儿窒息率(1.6%)显著低于对照组(12.8%,P0.05),初乳分泌时间明显短于对照组(P0.05),且纯母乳喂养率显著高于对照组(P0.05),产后抑郁倾向发生率显著低于对照组(P0.01)。结论:非药物分娩镇痛仪联合导乐陪伴分娩缩短了产程,降低了新生儿窒息率,减少了产后出血,也提高了自然分娩率和产妇的满意率。

A Clinical Study on the Non-drug Delivery Analgesics in Combination with Doula on the Facilitate Natural Delivery

ABSTRACT Objective: To explore the effect of non-drug delivery analgesia instrument (Doula instrument) combined with Doula accompaniment on delivery mode and delivery outcome. Methods: 450 Pregnant woman who delivered by traditional methods in the four affiliated hospitals of Harbin Medical University from August 2014 to August 2015 were divided into control group and 500 Preg- nant woman who delivered with Doula and Doula from September 2016 to September 2017 were divided into observation group. Pain score, delivery mode, duration of delivery, postpartum hemorrhage and neonatal asphyxia, early postpartum milk secretion time, exclu- sive breast feeding rate and the occurrence of postpartum depression were compared between the two groups. Results: Compared with the control group, the rate of moderate and severe pain in the observation group was significantly lower than that in the control group (P<0.01), the rate of cesarean section was significantly reduced, the total labor was significantly shortened, and the rate of intrapartum delivery was significantly increased (P<0.01). The postpartum blood loss of the observation group was 112.3±38.6 mL, significantly lower than that of the control group (152.7±80.5 mL, P<0.05). The rate of neonatal asphyxia (1.6%) in the observation group was significantly lower than that in the control group (12.8%, P<0.05), the duration of colostrum secretion was significantly shorter than that in the control group (P<0.05), the rate of exclusive breastfeeding was significantly higher than that in the control group(P<0.05), and the incidence of postpar- tum depression tendency was significantly lower than that in the control group(P<0.01). Conclusion: The combination of non-drug deliv- ery analgesia instrument and Doula accompanying delivery shortens the labor process, reduces the asphyxia rate of newborn, reduces postpartum hemorrhage, ensures the safety of mother and child, and improves the natural delivery rate and maternal satisfaction rate, which is worthy of clinical application and promotion.