冯颖?孙文丽?陈小冰

[摘要]目的 将全程导乐分娩运用在符合试产条件的产妇中，观察其对缩短经阴道分娩产程及减少产后并发症的作用。方法 选择2015年6月～2016年12月至我院产科进行待产的拟经阴道分娩的产妇118例作为研究对象，随机将入院当日日期为单号的为实验组，双号的为对照组，每组各59例。其中，单号组由有分娩经验的助产士进行全程陪伴护理，双号组给予常规护理。观察两组患者产程时间及并发症发生率的比较。 结果 经过全程导乐分娩干预的单号组第一产程用了（358.3±161.4）min，第二产程用了（46.2±22.3）min，第三产程用了（7.3±4.4）min，总产程为（411.8±188.1）min，分別低于双号组的第一产程（457.9±213.8）min、第二产程（55.7±34.5）min、第三产程（7.7±5.9）min、总产程（521.3±254.2）min，其中，第一产程、第二产程、总产程所用时间对比差异有统计学意义（P<0.05），第三产程所用时间差异无统计学意义（P>0.05），且单号组产后出血及尿潴留的发生率分别为1.69%、1.69%，分别低于双号组的8.47%、10.17%，两组患者评价指标差异有统计学意义（P<0.05）。 结论 全程导乐分娩有利于产妇更顺利分娩，缩短分娩所用时间，并减少产后并发症，提高分娩质量，值得推广。

[关键词]全程导乐分娩；产程；产后并发症；阴道分娩

[中图分类号] R714.3 [文献标识码] B [文章编号] 2095-0616（2017）16-135-04

Clinical effect evaluation of full Doula delivery in shortening the vaginal delivery process and reducing postpartum complications

FENG Ying SUN Wenli CHEN Xiaobing

Department of Obstetrics and Gynecology， Xinxing County Maternal and Child Health Care Center for Family Planning， Xinxing 527400， China

[Abstract] Objective The full use of Doula delivery in women with trial production conditions， to observe the vaginal delivery shorten birth process and reduce postpartum complications. Methods 118 cases in our hospital obstetric labor to vaginal delivery were selected as the study object. They were randomly divided into experimental group for the odd number， and control group for even number， each group of 59 cases， according to the admission date. Among them， the odd number group was attended by the midwife with childbirth experience， and the even number group received routine nursing care. Time of delivery and complication rate in two groups were observed and compared. Results The first stage of labor was （358.3±161.4） min， the second stage of labor was （46.2±22.3） min， the third stage of labor was （7.3±4.4） min， the total production process was （411.8±188.1） min in the odd number group with whole course of Doula delivery intervention， which were lower than those of even number group with （457.9±213.8） min for the first stage of labor， （55.7±34.5） min for the second stage of labor， （7.7±5.9） min for the third stage of labor， （521.3±254.2） min for the total production process， respectively. And， the first stage of labor， the second stage of labor， the total labor time required by the contrast differences， with statistical significance （P<0.05）. There was little difference in the time between the third stages of labor（P>0.05）. The incidence of postpartum hemorrhage and urinary retention in odd number group was 1.69%， and 1.69%， which were lower than those of even number group 8.47% and 10.17%， respectively. There were significant differences between the two groups （P<0.05）. Conclusion The full dorlar is conducive to maternal more smooth delivery， shorten the time spent by the delivery， and reduce postpartum complications， improve the quality of delivery， and it is worthy of promotion.endprint

[Key words] Full Doula delivery； Stage of labor； Postpartum complications； Vaginal delivery

近年来，由于人们对剖腹产的认识不足、剖腹产指征的放宽及初产妇缺乏对顺利分娩的信心和

分娩疼痛等因素，导致了剖腹产率上升[1-2]，据统计，我国部分地区的剖腹产率可高达70% ～80%[3]。剖腹产在带来缓解分娩疼痛的同时，也带来诸多安全隐患，如剖腹产后极易形成子宫瘢痕妊娠，不利于产妇产后恢复和新生儿的健康[4]。导乐分娩起源于美国，是目前国际卫生组织较为推荐的一种自然分娩理念[5]。其利用已分娩或经相关培训的助产士为产妇的整个产程提供服务，使其减少分娩痛苦，促进舒适[6]。……