杜晓娜 陈微微

[摘要] 目的 探讨丈夫陪伴联合镇痛分娩对初产妇母乳喂养的相关影响。 方法 选择年龄23～35岁，孕周37～41周，无阴道分娩禁忌证，愿意阴道试产、头位、足月单胎妊娠的初产妇400例。采用随机数字法随机分组：普通产时服务模式（A组）、丈夫陪伴分娩（B组）、镇痛分娩（C组）、丈夫陪伴联合镇痛分娩（D组），每组各100例。观察各组产妇的疼痛程度、心理状态、母乳喂养理论知识掌握情况、操作技巧测试结果、电话随访母乳喂养率与丈夫参与率等实验数据。 结果 丈夫陪伴联合镇痛分娩（D组）的产妇疼痛程度均显著低于其他三組，心理状态均显著优于其他三组，母乳喂养知识测评优良率均显著高于其他三组，母乳喂养操作技巧测试优良率均显著高于其他三组（P<0.05）。丈夫陪伴分娩（B组）与镇痛分娩（C组）的产妇疼痛程度均显著低于普通产时服务模式（A组），产妇心理状态均显著优于普通产时服务模式（A组），母乳喂养知识测评优良率均显著高于其他三组，母乳喂养操作技巧测试优良率均显著高于普通产时服务模式（A组）（P<0.05）。上述指标丈夫陪伴分娩（B组）与镇痛分娩（C组）之间比较无明显差异（P>0.05）。经电话随访，各组产妇均获得随访。随访结果显示，丈夫陪伴联合镇痛分娩（D组）的母乳喂养率与丈夫参与率均显著高于其他三组（P<0.05）。丈夫陪伴分娩（B组）与镇痛分娩（C组）的母乳喂养率与丈夫参与率均显著高于普通产时服务模式（A组）（P<0.05）。丈夫陪伴分娩（B组）与镇痛分娩（C组）之间比较无明显差异（P>0.05）。 结论 丈夫陪伴联合镇痛分娩模式下，可以有效降低初产妇疼痛程度，改善其心理状态，提高孕产妇及其丈夫的母乳喂养知识掌握水平及喂养操作技巧，并提高母乳喂养率与丈夫参与率。

[关键词] 初产妇；分娩；母乳喂养；丈夫陪伴；分娩镇痛

[中图分类号] R714.2 [文献标识码] B [文章编号] 1673-9701（2018）07-0053-04

[Abstract] Objective To investigate the related effects of company of husband combined with analgesia childbirth on the breastfeeding of primipara. Methods A total of 400 primiparae women who were 23-35 years of age， 37-41 weeks of gestational age， full-term singleton pregnancy without any contraindications of vaginal delivery and whose babies were cephalic position were selected. All patients were randomly divided into groups according to the random number method： normal intrapartum service mode （group A）， husband company delivery （group B）， analgesia （group C） and husband company combined with analgesia childbirth（group D）. Observed the maternal pain levels， psychological status， knowledge of breastfeeding theory， test results of operating skills， telephone follow-up breastfeeding rate and husband participation rate and other experimental data. Results The degree of maternal pain was significantly lower in the husband company combined with analgesia childbirth group（group D） than that in the other three groups. The psychological status was significantly better than the other three groups. The rate of excellent performance in breastfeeding knowledge assessment was significantly higher than the other three groups.The excellent rates of breastfeeding operation skills test were significantly higher than the other three groups（P<0.05）. The degree of maternal pain was lower in the husband company delivery group （group B） and analgesia delivery group （group C） than in the general intrapartum service group （group A）， and the maternal psychological status was significantly better than the general intrapartum service model group（group A） The rate of excellent performance in breastfeeding knowledge assessment were significantly higher than the other three groups， and The excellent rates of breastfeeding operation skills test were significantly higher than those of normal intrapartum service model group（group A） （P<0.05）. There was no significant difference between the indexes of husband company delivery group（group B） and analgesia delivery group（group C）（P>0.05）. All groups of women were followed up by telephone. The follow-up results showed that the rate of breast-feeding and the rate of husband participation were significantly higher in husband company combined with analgesia childbirth group（D group） than in the other three groups（P<0.05）. The rates of breastfeeding and husband participation in husband company delivery group （group B） and analgesia delivery group （group C） were significantly higher than those in group A（P<0.05）. There was no significant difference between husband company delivery group （group B） and analgesia delivery group （group C）（P>0.05）. Conclusion Husband company combined with analgesia childbirth can effectively reduce the degree of maternal pain of primipara， improve their psychological status， improve the knowledge of breastfeeding and and feeding skills of the pregnant woman and her husband， and improve the rate of breastfeeding and husband participation .

[Key words] Primipara； Childbirth； Breastfeeding； Husband company； Labor analgesia

生产过程中，在不同的产程，孕妇会产生不同程度的疼痛感，这种产痛对母婴都会造成不良影响。尤其对初产妇而言，会对分娩过程产生一定的紧张、焦虑等心理和不良情緒。在分娩过程中受到疼痛等因素的影响，会进一步加剧其紧张和焦虑等程度[1]。……