丈夫陪产配合导乐陪产应用于产妇分娩过程中对产程用时、分娩结局及满意度的影响

　　[摘要] 目的 观察产妇分娩过程中应用丈夫陪产配合导乐陪产对产程用时、分娩结局及满意度的影响。 方法 选取2015年7月～2017年7月在我院分娩的128例产妇的临床资料，按方案不同分为两组，各64例，对照组行传统分娩方式，观察组行丈夫陪产配合导乐陪产，比较组间产程、分娩结局及满意度。 结果 观察组第一、第二、第三产程为（7.35±0.23）h、（0.74±0.05）h、（0.12±0.01）h及总产程（8.23±0.34）h均比对照组（8.36±0.34）h、（0.96±0.11）h、（0.19±0.02）h、（9.63±0.36）h短（P<0.01）；观察组自然分娩率（85.94%）比对照组（53.13%）高，剖宫产率（14.06%）比对照组（46.89%）低（P<0.01），观察组产后2 h出血量比对照组少；观察组总满意（93.75%）比对照组（71.88%）高（P<0.01）。结论 产妇分娩通过丈夫陪产联合导乐陪产能显著缩短产程，提高自然分娩率，减少产后出血，提升满意度。
　　[关键词] 产妇分娩；丈夫陪产；导乐陪产；产程；分娩结局
　　[中图分类号] R714.3 [文献标识码] B [文章编号] 1673-9701（2018）08-0059-04
　　Effect of delivery accompanied by husband and doula on stage of labor， delivery outcome and satisfaction during labor
　　LIU Zhengjie ZHANG Shengyan
　　Department of Obstetrics and Gynecology， Ruian Maternal and Child Health Care Hospital in Zhejiang Province， Ruian 325200， China
　　[Abstract] Objective To investigate the effects of delivery accompanied by husband and doula on stage of labor， delivery outcome and satisfaction during maternal delivery. Methods The clinical data of 128 puerpera delivering in our hospital from July 2015 to July 2017 were divided into 2 groups with 64 cases in each group. The control group received traditional delivery mode. The observation group used husband accompanied and doula accompanied delivery method. Stage of labor， delivery outcomes and satisfaction were compared between groups. Results The first， second and third stage of labor（7.35±0.23）h，（0.74±0.05） h，（0.12±0.01） h and total stage of labor（8.23±0.34）were shorter compared with the control group （8.36±0.34）h， （0.96±0.11） h，（0.19±0.02）h and（9.63±0.36） h， respectively（P<0.01）. The rate of spontaneous labor in the observation group was 85.94%， which was higher than that in the control group（53.13%）. The rate of cesarean was 14.06%， which was lower than control group （46.89%）（P<0.01）. The amount of 2 h-postpartum hemorrhage in the observation group was less than the control group.The total satisfaction rate of the observation group was 93.75% which was higher than the control group（71.88%）（P<0.01）. Conclusion Maternal delivery accompanied by husband and doula can significantly shorten the stage of labor， increase the rate of spontaneous labor， reduce the postpartum hemorrhage and improve the satisfaction.
　　[Key words] Maternal childbirth； Husband accompanied delivery； Doula accompanied delivery； Stage of labor； Delivery outcome
　　分娩是具有應激性的一种生理过程，产妇是分娩的唯一承受对象，其在分娩前、分娩中均存在系列情绪变化，例如紧张、害怕、焦急、抑郁等，这种负面情绪不利于产妇分娩的进程，易引起宫缩乏力、宫内窘迫等诸多分娩并发症，危害母婴结局[1]。子宫收缩所引起的阵发性疼痛是导致产妇分娩期不良情绪变化的主要原因，而分娩引起的恐惧、疼痛则是导致产妇选择剖宫产分娩的主要因素[2]。产妇在分娩时感受到的剧烈疼痛使得其肌肉紧绷，抑制血管、子宫进行收缩，继而阻碍分娩进程，延缓产程，增加疼痛感，导致妊娠不良结局[3]。导乐陪产是近年产科兴起的一种新型分娩模式，在分娩全程中予以产妇情感、生理、心理支持，以增强产妇自我效能感，优化分娩质量的一种手段[4]。以往产妇分娩拒绝一切除医护人员以外的人员进入产房，但是，近几年许多医院开始允许丈夫陪产，这对产妇分娩起到一定的支持作用。为探讨丈夫陪产联合导乐陪产的应用效果，我院以2015年7月～2017年7月接收的128例产妇作为研究对象，现报道如下。

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