自由体位分娩在第一产程中的应用观察.docVIP

自由体位分娩在第一产程中的应用观察 　　[摘要]目的 探讨产妇分娩时在第一产程中采取自由体位的临床应用效果。方法 选取2014年9月～2016年9月我院收治的112例待产产妇作为研究对象，按随机数字表法分为观察组与对照组，每组各56例。观察组产妇在第一产程中可采用蹲、卧、坐、跪、立、走等自由体位分娩，对照组产妇采取常规体位进行分娩，比较两组产妇的临床疗效。结果 观察组产妇中自然分娩50例，剖宫产4例，阴道助产2例，自然分娩率（87.50%）明显高于对照组（73.21%），差异有统计学意义（P0.05）。结论 在第一产程中采取自由体位分娩，能够增加产妇舒适感，调动产妇的主观能动性，促进其自然分娩，降低剖宫产率和并发症发生率，更有利于保障母婴健康。 　　[关键词]自由体位；第一产程；分娩方式 　　[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2017）10（a）-0129-03 　　[Abstract]Objective To observe the clinical application effect of delivery in liberal position at the first-stage labor.Methods From January 2014 to September 2016，112 puerperae for delivery admitted into our hospital were selected as research objects.By a random number method，they were evenly divided into two groups.In observation group，labor in liberal position like squatting，lying，sitting，kneeling，standing，and walking was available for puerperae at the first-stage labor.In control group，regular position for delivery was adopted.The clinical effect in the two groups was compared.Results In the observation group，there were 50 puerperae in spontaneous labor，4 in cesarean section and 2 in vaginal assistant labor，the proportion of spontaneous delivery in observation group （87.50%） was significantly higher than that in control group （73.21%），the difference was statistically significant （P0.05）.Conclusion Selection of liberal position at the first-stage labor can increase maternal comfort，mobilize their subjective initiative，promote spontaneous labor，reduce the incidence of cesarean section and complications，which is beneficial to safeguard maternal and child health. 　　[Key words]Liberal position；First stage of labor；Delivery mode 　　?S着时代的进步，产妇分娩时的母婴健康愈来愈受到人们的重视。而分娩过程中如何降低剖宫产率、避免会阴侧切以及胎儿窒息等并发症的发生，则成为了产科医务人员的关注重点[1]。我国产妇分娩时大多还全程采用传统的仰卧体位。但是在第一产程中如果产妇长时间处于仰卧体位可能会压迫腹部大血管，影响胎盘供血，另外产妇在呈仰卧体位时骨盆会变得相对狭窄，增加胎头下降的阻力，从而引起产力减弱、产程延长、增大分娩难度[2-3]。近年来不少报道指出，分娩时应尽量避免长时间处于平卧位[4-5]，可以多变换体位，如站、卧、蹲、走等体位，会对促进自然分娩产生积极效果。2006年，WHO也发布了倡导采取自由体位进行分娩的分娩指导原则[6]。自由体位分娩是指产妇在分娩时可以采取蹲、卧、坐、