早期人工破膜后联合无痛分娩对初产妇产程?(1)
【摘要】 目的：探讨对初产妇实施早期人口破膜联合无痛分娩对产妇产程、母婴结的影响。方法：选取笔者所在医院2015年1月-2019年1月收治的60例初产妇为研究对象，随机分成观察组与对照组，各30例。对照组予以常规助产士分娩及早期人工破膜干预，而观察组则实施早期人工破膜联合无痛分娩干预，观察两组产妇产程及母婴结局情况。结果：观察组第一、二、三产程时间均短于对照组，差异均有统计学意义(P<0.05);观察组剖宫产率、产后出血率及新生儿窒息分别为10.00%、3.33%、0，对照组分别为33.33%、20.00%、13.33%，组间比较差异均有统计学意义(P<0.05)。结论：针对临床的初产妇，实施早期人工破膜联合无痛分娩的干预方式，可以缩短产妇产程时间，改善母婴结局，值得推广。
【关键词】 早期人工破膜 无痛分娩 初产妇 产程时间 母婴结局
[Abstract] Objective： To investigate the effect of early-stage rupture of membrane and euthanasia on maternal labor and maternal-fetal knots in primipara. Method： Sixty primiparas from January 2015 to January 2019 in our hospital were selected as subjects. They were randomly divided into observation group and control group， 30 cases in each group. The control group was given conventional midwife delivery and early artificial membrane rupture intervention. In the observation group， early artificial rupture of membrane combined with painless labor intervention was performed. Observe the maternal labor and maternal and child outcomes. Result： The observation group was shorter than the control group in the first， second and third stage of labor， the differences were statistically significant (P<0.05). The incidence of cesarean section， postpartum hemorrhage and neonatal asphyxia in the observation group were 10.00， 3.33% and 0， respectively. The indexes in the control group were 33.33%， 20.00%， and 13.33%， respectively. The differences between the groups were statistically significant (P<0.05). Conclusion： For clinical primiparas， the implementation of early artificial rupture combined with painless delivery can shorten the maternal labor time and improve maternal and child outcomes， which is worth promoting.
隨着生活水平的不断提高，人们对自身健康及身体舒适度的要求越来越高[1]。在医院产科护理中，初产妇对产科服务的要求也不断提高，因此加强初产妇的护理干预也成为临床中研究的重点。针对临产的初产妇，一般是由助产护士陪同产妇进行分娩，并注意在分娩过程监测产妇呼吸、血压及宫缩频率等，保证分娩的顺利进行，此外还提倡实施早期人工破膜。人工破膜是指人为将宫口羊膜撕破，这样可观察羊膜内羊水情况，增加孕妇宫缩频率及强度，提升引产成功率[2]。然而单纯行早期人工破膜对产程及母婴结局影响不明显[3]。近年来，随着无痛分娩技术的发展，笔者所在医院针对临产的初产妇，实施早期人工破膜后联合无痛分娩的干预模式，取得了满意效果，报告如下。
1 资料与方法
1.1 一般资料
选取2015年1月-2019年1月笔者所在医院临产的60例初产妇为研究对象。纳入标准：均为单胎且足月妊娠[4];产妇有完整的临床资料。排除标准：无法配合研究;有其他严重疾病。产妇均签署知情同意书，研究符合医学伦理学要求。按随机数字表法将产妇分为两组，观察组30例，年龄21～37岁，平均(28.5±1.3)岁;孕周37～41周，平均(39.2±0.8)周。对照组30例，年龄22～37岁，平均(28.2±1.3)岁;孕周37～41周，平均(38.8±0.8)周。两组一般资料比较，差异无统计学意义(P>0.05)，有可比性。
1.2 方法
对照组实施常规分娩及早期人工破膜干预，主要是产妇分娩的时候，辅助产妇为传统卧位，每一名产妇对应一名助产士，指导产妇在分娩过程如何呼吸，监测产妇宫缩频率、血压及心率等，持续干预到产妇顺利完成分娩。观察宫口开出0.5～1.0 cm就可进行人工破膜，操作如下：先让产妇将排尿使膀胱排空，然后辅助产妇为截石位，对外阴进行常规消毒，借助阴道内镜观察产妇阴道、子宫内部情况，操作者将中指、食指深入阴道探查产道情况，两指深入宫颈探查脐带情况，之后操作者左后持鼠齿钳，右手引导触摸羊膜囊钳破，注意操作轻柔，若羊水少者可以上推胎头或者使用手指扩张胎膜以使羊水可顺利流出;羊膜囊羊水充足者用注射针头，在两次宫缩间歇期刺破羊膜囊，使得羊水顺利流出;羊膜囊不明显这利用窥阴器进行破膜处理，避免胎儿头皮损伤。, 百拇医药(孙启祥 王丽雯 单锦妹)
【关键词】 早期人工破膜 无痛分娩 初产妇 产程时间 母婴结局
[Abstract] Objective： To investigate the effect of early-stage rupture of membrane and euthanasia on maternal labor and maternal-fetal knots in primipara. Method： Sixty primiparas from January 2015 to January 2019 in our hospital were selected as subjects. They were randomly divided into observation group and control group， 30 cases in each group. The control group was given conventional midwife delivery and early artificial membrane rupture intervention. In the observation group， early artificial rupture of membrane combined with painless labor intervention was performed. Observe the maternal labor and maternal and child outcomes. Result： The observation group was shorter than the control group in the first， second and third stage of labor， the differences were statistically significant (P<0.05). The incidence of cesarean section， postpartum hemorrhage and neonatal asphyxia in the observation group were 10.00， 3.33% and 0， respectively. The indexes in the control group were 33.33%， 20.00%， and 13.33%， respectively. The differences between the groups were statistically significant (P<0.05). Conclusion： For clinical primiparas， the implementation of early artificial rupture combined with painless delivery can shorten the maternal labor time and improve maternal and child outcomes， which is worth promoting.
隨着生活水平的不断提高，人们对自身健康及身体舒适度的要求越来越高[1]。在医院产科护理中，初产妇对产科服务的要求也不断提高，因此加强初产妇的护理干预也成为临床中研究的重点。针对临产的初产妇，一般是由助产护士陪同产妇进行分娩，并注意在分娩过程监测产妇呼吸、血压及宫缩频率等，保证分娩的顺利进行，此外还提倡实施早期人工破膜。人工破膜是指人为将宫口羊膜撕破，这样可观察羊膜内羊水情况，增加孕妇宫缩频率及强度，提升引产成功率[2]。然而单纯行早期人工破膜对产程及母婴结局影响不明显[3]。近年来，随着无痛分娩技术的发展，笔者所在医院针对临产的初产妇，实施早期人工破膜后联合无痛分娩的干预模式，取得了满意效果，报告如下。
1 资料与方法
1.1 一般资料
选取2015年1月-2019年1月笔者所在医院临产的60例初产妇为研究对象。纳入标准：均为单胎且足月妊娠[4];产妇有完整的临床资料。排除标准：无法配合研究;有其他严重疾病。产妇均签署知情同意书，研究符合医学伦理学要求。按随机数字表法将产妇分为两组，观察组30例，年龄21～37岁，平均(28.5±1.3)岁;孕周37～41周，平均(39.2±0.8)周。对照组30例，年龄22～37岁，平均(28.2±1.3)岁;孕周37～41周，平均(38.8±0.8)周。两组一般资料比较，差异无统计学意义(P>0.05)，有可比性。
1.2 方法
对照组实施常规分娩及早期人工破膜干预，主要是产妇分娩的时候，辅助产妇为传统卧位，每一名产妇对应一名助产士，指导产妇在分娩过程如何呼吸，监测产妇宫缩频率、血压及心率等，持续干预到产妇顺利完成分娩。观察宫口开出0.5～1.0 cm就可进行人工破膜，操作如下：先让产妇将排尿使膀胱排空，然后辅助产妇为截石位，对外阴进行常规消毒，借助阴道内镜观察产妇阴道、子宫内部情况，操作者将中指、食指深入阴道探查产道情况，两指深入宫颈探查脐带情况，之后操作者左后持鼠齿钳，右手引导触摸羊膜囊钳破，注意操作轻柔，若羊水少者可以上推胎头或者使用手指扩张胎膜以使羊水可顺利流出;羊膜囊羊水充足者用注射针头，在两次宫缩间歇期刺破羊膜囊，使得羊水顺利流出;羊膜囊不明显这利用窥阴器进行破膜处理，避免胎儿头皮损伤。, 百拇医药(孙启祥 王丽雯 单锦妹)