Application value of midwife-led partnership-based Doula delivery in the childbirth nursing of primiparas
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摘要:目的 探讨助产士主导伙伴式导乐陪伴在初产妇分娩护理中的应用价值。方法 回顾性分析176例分娩初产妇临床资料, 根据干预方法分为观察组80例和对照组96例。观察组予以助产士主导伙伴式导乐陪伴干预，对照组行常规干预。比较2组分娩产程时间、分娩结局，评估总体分娩疼痛及焦虑感、分娩控制感。结果 观察组第一产程、第二产程及总产程时间均短于对照组(P < 0.05); 观察组产后出血量、会阴侧切率、会阴裂伤率均低于对照组(P < 0.05)，2组新生儿apgar评分 < 8分率对比差异无统计学意义(P>0.05); 观察组疼痛视觉模拟评分法(VAS)及视觉模拟焦虑量表(VAS-A)得分均低于对照组(P < 0.05); 观察组分娩控制感量表(LAS)得分高于对照组(P < 0.05)。结论 助产士主导伙伴式导乐陪伴能产生良好镇痛和缓解焦虑效果，促进产程加快和分娩结局改善。Abstract:Objective To explore the application value of midwife-led partnership-based Doula delivery in the childbirth nursing of primiparas.Methods The clinical materials of 176 primiparas were retrospectively analyzed. According to the intervention methods, they were divided into observation group (n=80) and control group (n=96). Observation group was given midwife-led partnership-based Doula delivery, and control group was given routine intervention. The labor delivery time and delivery outcomes were compared between the two groups, and the overall labor pain [pain visual analogue scale (VAS)], anxiety [visual analogue scale-anxiety (VAS-A)] and childbirth control sense [labour agentry scale (LAS)] were evaluated.Results The first stage of labor, second stage of labor and total labor time in observation group were significantly shorter than those in control group (P < 0.05). The postpartum hemorrhage, lateral episiotomy rate and perineal laceration rate in observation group were significantly lower than those in control group (P < 0.05), and there was no significant difference in the rate of neonatal apgar score < 8 points between the two groups (P>0.05). The scores of VAS and VAS-A in observation group were significantly lower than those in control group (P < 0.05). The LAS score in observation group was significantly higher than that in control group (P < 0.05).Conclusions Midwife-led partnership-based Doula delivery can produce good analgesia and anxiety relief effect, and promote the acceleration of labor and improve the delivery outcomes.
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Keywords:
- primiparas /
- delivery /
- midwife /
- partnership-based Doula delivery
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表 1 2组分娩产程时间对比(x±s)
min 组别 第一产程 第二产程 总产程 对照组(n=96) 668.36±188.39 37.04±10.59 602.95±187.30 观察组(n=80) 447.07±139.16* 31.57±7.57* 528.11±148.68* 与对照组比较, *P < 0.05。 
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表 2 2组分娩结局对比(x±s)[n(%)]
指标 对照组(n=96) 观察组(n=80) 产后出血量/mL 319.25±62.25 244.69±46.34* 会阴侧切 16(16.67) 3(3.75)* 会阴裂伤 10(10.42) 2(2.50)* 新生儿apgar评分 < 8分 3(3.13) 0 与对照组比较, *P < 0.05。
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表 3 2组分娩疼痛及焦虑感得分对比(x±s)
分 组别 分娩疼痛 焦虑感 对照组(n=96) 7.80±1.59 7.55±2.11 观察组(n=96) 5.19±1.04* 4.79±1.44* 与对照组比较, *P < 0.05。
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