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目的 探讨自由体位联合拉玛泽呼吸法在缓解阴道分娩产妇产程疼痛中的应用。方法 选取北京市丰台中西医结合医院妇产科2016年12月至2017年2月收治的210例产妇为观察组,采用自由体位联合拉玛泽呼吸法分娩。选取该院妇产科2016年9至11月收治的220例产妇为对照组,采用常规体位分娩。比较两组产妇的产程疼痛、产程进展、母婴结局等。结果观察组疼痛程度分级较低,以0级、Ⅰ级疼痛为主,对照组疼痛程度分级较低,以Ⅱ级为主,两组产妇产程疼痛分级经Fisher确切概率法检验有显著性差异,观察组优于对照组(P<0.01)。观察组第一产程中的加速期时间、第二产程、总产程时间均显著短于对照组(t值分别为-3.681、-4.567、-2.451,均P<0.05),两组产妇潜伏期、减速期均无显著性差异(t值分别为-0.522、-1.682,均P>0.05)。观察组转剖宫产率、胎儿宫内窘迫率、新生儿窒息率、产后出血率均显著低于对照组(χ2值分别为8.462、12.394、9.005、4.537,均P<0.05)。结论 自由体位联合拉玛泽呼吸法能够减少阴道分娩产妇产程疼痛,促进产程进展,降低剖宫产率,改善母婴结局。
Objective To explore the application of free position combined with Ramazal respiration in alleviating labor-induced pain in vaginal delivery. Methods A total of 210 maternal women admitted to the Department of Obstetrics and Gynecology, Fengtai Hospital of Integrated Traditional Chinese and Western Medicine in Beijing from December 2016 to February 2017 were selected as observation group and delivered by free position combined with Ramaze respiration. Select the hospital obstetrics and gynecology 2016 September to November admitted 220 cases of maternal control group, the use of conventional physical delivery. The two groups of maternal labor pain, labor progress, maternal and infant outcomes. Results The grade of pain in the observation group was lower than that of the control group. The grade 0 and grade Ⅰ pain were the main symptoms. The pain grade in the control group was lower than the grade Ⅱ. The pain grading of the two groups was significantly different by Fisher exact test. The observation group was better than the control group (P <0.01). The acceleration time, the second stage of labor and the total labor duration of the first stage of labor in the observation group were significantly shorter than those in the control group (t = -3.681, -4.567, -2.451, all P <0.05). The incubation period, There was no significant difference (t = -0.522, -1.682, all P> 0.05). The cesarean section rate, fetal distress rate, neonatal asphyxia rate and postpartum hemorrhage rate in the observation group were significantly lower than those in the control group (χ2 = 8.462,12.394,9.005,4.537, all P <0.05). Conclusion Free body position combined with Ramazha respiratory can reduce vaginal delivery maternal labor pain, promote labor progress, reduce cesarean section rate and improve maternal and infant outcomes.