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目的探讨拉玛泽呼吸法配合无保护接产技术对产妇负性情绪及分娩结局的影响,旨在为产科提高分娩质量和护理服务提供有效依据。方法将2015年1—12月在杭州市红十字会医院建卡产检、分娩的460例低危初产妇随机分为对照组和观察组各230例,对照组采用传统的保护会阴技术分娩;观察组孕28周起接受拉玛泽呼吸法学习且坚持每天练习直到临产并配合无保护会阴接产技术分娩;采取焦虑自评量表(SAS)和抑郁自评量表(SDS)评价2组初产妇负性情绪状况,观察并比较2组产妇的会阴裂伤、第二产程时间、产后出血量及新生儿窒息的发生情况。结果观察组初产妇分娩前12 h内SAS评分[(33.20±9.53)分]及SDS评分[(31.15±6.44)分]均低于对照组SAS评分[(64.38±5.50)分]及SDS评分[(61.89±5.09)分],差异均有统计学意义(t=42.96、56.79;均P<0.001);观察组会阴完整率为12.17%,Ⅱ度会阴裂伤发生率为25.65%(59/230),对照组会阴完整率为2.61%,Ⅱ度会阴裂伤发生率为39.13%(90/230),观察组会阴完整及Ⅱ度裂伤情况明显低于对照组(χ~2=14.01、9.54;均P<0.05);观察组产后出血量[(225.12±46.12)ml]低于对照组产后出血量[(248.20±50.28)ml],差异有统计学意义(t=5.13,P<0.05);观察组新生儿窒息4例(1.74%),低于对照组的19例(8.26%),差异有统计学意义(χ~2=10.30,P<0.05)。结论采用拉玛泽呼吸法配合无保护会阴接产技术能改善初产妇负性情绪,减少会阴损伤,减少产后出血及新生儿窒息,促进自然分娩。
Objective To explore the influence of Lamaze respiration method combined with unprotected intercourse technology on maternal negative emotions and delivery outcomes and to provide an effective basis for obstetrics to improve the quality of delivery and nursing services. Methods From January to December in 2015, 460 cases of low risk primipara in Hangzhou Red Cross Hospital were randomly divided into control group and observation group, with 230 cases in control group and observation group. The control group was given traditional protection of perineal technique. Group 28 received gestational Ramamax respiration study and insisted on daily practice until the abortion and unprotected perineal delivery technology delivery; using self-rating anxiety scale (SAS) and depression self-rating scale (SDS) Maternal negative emotional state, observation and comparison of the two groups of maternal perineal laceration, the second stage of labor time, postpartum hemorrhage and neonatal asphyxia occurred. Results SAS score [(33.20 ± 9.53) min] and SDS score [(31.15 ± 6.44) min) in the observation group before delivery were both lower than those in the control group [(64.38 ± 5.50)] and SDS score [ (61.89 ± 5.09), the differences were statistically significant (t = 42.96,56.79; all P <0.001). The perineal completeness rate was 12.17% in the observation group and 25.65% in the second degree perineal laceration (59/230 ) In the control group, 2.61% in the control group and 39.13% (90/230) in the second degree episiotomy. The perineal integrity and grade Ⅱ laceration in the observation group were significantly lower than those in the control group (χ ~ 2 = 14.01 and 9.54 ; All P <0.05). The postpartum hemorrhage volume in the observation group was lower than that in the control group [(245.20 ± 50.28) ml] [(225.12 ± 46.12) ml] (t = 5.13, P < . The incidence of asphyxia in observation group was 4 cases (1.74%), which was lower than that in control group (19 cases, 8.26%), the difference was statistically significant (χ ~ 2 = 10.30, P <0.05). Conclusion Lamaze respiration combined with unprotected perineal intercourse technique can reduce the negative emotion of primipara, reduce perineal injury, reduce postpartum hemorrhage and neonatal asphyxia, and promote natural childbirth.