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目的评估剖宫产和自然分娩后产妇急性疼痛的感觉、情感、单侧性疼痛等影响因素分析。方法随机选择2013年7月至2014年12月湖北医药学院附属随州医院定期产检及住院分娩的初产妇。应用评分量表来评估产后1、3d,产妇在休息、活动时疼痛程度及疼痛位置。采用SPSS 19.0软件分析,计量资料以x±s表示,采用Student t检验,计数资料以百分率表示,采用χ2检验,P<0.05为差异有统计学意义。结果 174例入组产妇中,行剖宫产83例,阴道自然分娩91例。产后1d,剖宫产组产妇较自然分娩产妇在活动时、24h疼痛评分更高,而且单侧性疼痛出现概率高,差异均有统计学意义(P<0.01)。产后3d,剖宫产组产妇较自然分娩组产妇有疼痛体验,无论是静息、活动、24h疼痛体验,并且出现明显的偏侧性疼痛,差异有统计学意义(P<0.05)。在亚组分析中,无论剖宫产还是自然分娩,产妇孕期的高BMI值、不良抑郁或焦虑病史、孕晚期缺乏运动锻炼均与产后疼痛密切相关,差异有统计学意义(P<0.05)。自然分娩的产妇产后疼痛体验还与孕期慢性疼痛病史、会阴侧切、第一产程时间过长密切相关,差异有统计学意义(P<0.05)。结论与自然分娩方式相比,剖宫产分娩与更高程度的疼痛、更加不悦的疼痛及更多偏头痛相关。对分娩后疼痛相关因素的评估能够帮助临床医生为孕产妇选择最佳分娩方式提供有意义的临床参考。
Objective To evaluate the influencing factors such as the feeling of maternal acute pain after cesarean and spontaneous delivery, emotion, unilateral pain and so on. Methods A random sample of primipara between July 2013 and December 2014 at Suizhou Hospital affiliated to Hubei Medical College was conducted. The application of grading scale to assess the postpartum 1d, maternal rest, activity, pain and pain location. Using SPSS 19.0 software analysis, measurement data to x ± s said, using Student t test, count data expressed as a percentage, using χ2 test, P <0.05 was considered statistically significant. Results 174 cases of the group of women, cesarean section in 83 cases, 91 cases of spontaneous vaginal delivery. Postpartum 1d, cesarean section than mothers spontaneous spontaneous activity, 24h pain score higher, and the high incidence of unilateral pain, the difference was statistically significant (P <0.01). Postpartum women in the cesarean section had a painful experience than those in the spontaneous delivery group, both in terms of rest, activity, and 24h pain experience, and significant lateral pain was observed with significant differences (P <0.05). In the subgroup analysis, regardless of cesarean section or natural childbirth, the high BMI of pregnant women during pregnancy, the history of poor depression or anxiety, the lack of exercise during late pregnancy and postpartum pain were closely related, the difference was statistically significant (P <0.05). The experience of postpartum pain in spontaneous labor was also closely related to the history of chronic pain in pregnancy, episiotomy, long time of the first stage of labor, the difference was statistically significant (P <0.05). Conclusion Cesarean delivery is associated with higher levels of pain, more unpleasant pain, and more migraines than spontaneous delivery. Assessment of pain-related factors after childbirth can help clinicians provide meaningful clinical references for choosing the best mode of delivery for pregnant women.