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目的:探讨在产程中进行体位管理及穴位按摩对枕后位初产妇胎位校正情况、分娩方式及母儿结局的影响。方法:选择2014年6月—2015年7月在中国医科大学附属盛京医院第一分娩室适合进行试产的232例枕后位初产妇为研究对象,并随机分为观察组和对照组。观察组于第一及第二产程对产妇进行相关体位指导、管理及穴位按摩,胎头拔露后回产床半卧位至胎儿娩出。对照组不限制体位,宫口开全后回产床半卧位至胎儿娩出,其他干预措施一致。结果:观察组纠正为枕前位的例数多于对照组,差异有统计学意义(P<0.05);观察组经阴道分娩率大于对照组,产钳助产率、剖宫产率小于对照组,差异有统计学意义(P<0.05);观察组第一产程及第二产程时间小于对照组,差异有统计学意义(P<0.05);观察组疼痛感及镇痛分娩比例低于对照组,差异有统计学意义(P<0.05);产后出血量低于对照组,差异有统计学意义(P<0.05);新生儿窒息率低于对照组,差异有统计学意义(P<0.05)。结论:产程中对枕后位初产妇合理进行体位管理可纠正枕后位,进行适当的穴位按摩,可促进气血流通、降低分娩疼痛,二者合用是提高阴道分娩率、缩短产程、缓解产痛、降低产后出血量及新生儿窒息率的有效方法。
OBJECTIVE: To investigate the effect of position management and acupoint massage in the labor process on the correction of fetal head position, delivery mode and maternal and child outcomes after occipital posterior position. Methods: From June 2014 to July 2015, 232 cases of primiparous primiparous women who were suitable for trial production in the first delivery room of Shengjing Hospital Affiliated to China Medical University were selected as research object and randomly divided into observation group and control group. Observation group in the first and second stage of maternal mothers for the relevant position guidance, management and acupressure, fetal head and back to the semi-reproductive bed to the fetus. The control group does not limit body position, cervix open full bed to semi-recumbent fetal delivery, the other interventions consistent. Results: The number of cases corrected in the anterior occipital position was significantly higher in the observation group than in the control group (P <0.05). The vaginal delivery rate in the observation group was greater than that in the control group. The forceps delivery rate and cesarean section rate were lower than those in the control group , The difference was statistically significant (P <0.05); the observation group, the first stage of labor and the second stage of labor was shorter than the control group, the difference was statistically significant (P <0.05); observation group pain and analgesic delivery was lower than the control group , The difference was statistically significant (P <0.05); postpartum hemorrhage was lower than the control group, the difference was statistically significant (P <0.05); neonatal asphyxia rate was lower than the control group, the difference was statistically significant (P <0.05) . Conclusion: The management of postpartum primiparous position can correct the posterior position of the occiput posterior part of the labor and correct acupoint massage can promote the circulation of qi and blood and reduce the pain of childbirth. The combination of the two is to improve the vaginal delivery rate, shorten the labor process and ease the labor Pain, reduce the amount of postpartum hemorrhage and neonatal asphyxia effective method.