任志容 彭晓梅

〔摘要〕 目的 探討中医穴位按摩联合导乐分娩对初产妇负性情绪、乳房胀痛及分娩结局的影响。方法 选取2017年1月至2018年2月本院收治的初产妇173例作为研究对象，按随机抽样的原则分为对照组86例（给予常规分娩护理）与联合组87例（在对照组基础上给予中医穴位按摩联合导乐分娩）。对两组初产妇均进行为期2周的跟踪随访，记录并比较两组初产妇负性情绪评分、乳房胀痛程度评级情况、分娩情况以及妊娠结局。结果 护理后联合组SAS评分、SDS评分均明显低于对照组（P<0.05）;联合组乳房胀痛程度明显轻于对照组（P<0.05）;联合组初产妇剖宫产率、潜伏期VAS评分以及活跃期VAS评分均明显低于对照组，第一产程时间、第二产程时间以及产后出血量均明显少于对照组（P<0.05）;联合组新生儿1min Apgar评分略高于对照组（P>0.05）;联合组初产妇胎儿窒息、产褥感染、产后出血以及早产发生率均明显低于对照组（P<0.05）。结论 通过对初产妇分娩过程中给予中医穴位按摩联合导乐分娩可明显改善负性情绪，减轻乳房胀痛程度，有利于产程进展及减少产后出血量，提高自然分娩率，可有效保障母婴安全。

〔关键词〕 初产妇;负性情绪;分娩结局;穴位按摩;导乐分娩

〔中图分类号〕R245.9       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.05.022

〔Abstract〕 Objective To discuss the effects of traditional Chinese medicine acupoint massage combined with doula delivery on negative emotion， breast distending pain and delivery outcome of primipara. Methods A total of 173 cases of primiparas in our hospital were selected as the research subjects from January 2017 to February 2018， according to the principle of random sampling， with 86 cases in the control group （given routine childbirth nursing） and 87cases in the combined group （given traditional Chinese medicine acupoint massage combined with doula delivery on the basis of the control group）. The two groups of primipara were followed up for 2 weeks. The negative emotion scores， breast distending pain rating， delivery condition and pregnancy outcomes of the primipara were recorded and compared between the 2 groups. Results After nursing， the self-rating anxiety scale （SAS） score， self-rating depression scale （SDS） score in the combined group were significantly lower than those in the control group （P<0.05）. The breast distending pain in the combined group was significantly less than that in the control group （P<0.05）. The cesarean section rate， latent VAS score and active VAS score in the combined group primiparas were significantly lower than those in the control group， and the time of the first stage of labor， the second stage of labor and the amount of postpartum hemorrhage in the combined group were significantly shorter than those in the control group （P<0.05）; the l min Apgar score in the combined group was slightly higher than those in the control group （P>0.05）. The incidence of fetal asphyxia， puerperal infection， postpartum hemorrhage and the premature delivery in the combined group were significantly lower than those in the control group （P<0.05）. Conclusion By giving primipara traditional Chinese medicine acupoint massage combined with doula delivery， it can significantly improve negative emotions， reduce the breast distending pain， facilitate the progress of labor and reduce the amount of postpartum hemorrhage， improve the rate of natural delivery， and effectively guarantee the safety of mother and infant.

〔Keywords〕 primipara; negative emotion; delivery outcome; traditional Chinese medicine acupoint massage; doula delivery

因初产妇缺乏分娩经验及对孕期相关知识了解较少，极易对分娩产生恐惧心理，在分娩不同时期均会伴有焦虑、抑郁、孤独等负性情绪，甚至造成产妇产后出血量增加，严重影响初产妇顺利分娩，不利于母婴健康[1-2]。导乐分娩是在对产妇身体状况与心理状态全面了解的基础上提出的一种新型分娩护理模式，可有效增强产妇信心并缓解产婦负性情绪[3]。而中医穴位按摩是以中医基础理论为指导，根据穴位的特定功能配合相应的按摩手法，以此来缓解产妇宫缩时疼痛，对缓解宫缩乏力以及缩短产程也有较好的效果[4]。为此本研究选取2017年1月至2018年2月本院收治的初产妇173例作为研究对象，探讨中医穴位按摩联合导乐分娩对初产妇负性情绪、乳房胀痛及分娩结局的影响，现报道如下。……