全程连续性助产护理对剖宫产术后阴道分娩产妇产痛程度及产程的影响

摘要

Objective:To investigate the effect of continuity midwifery care on labor pain and duration of labor in vaginal birth after cesarean(VBAC)delivery.Methods:A total of 1 12 pregnant women who preferred VBAC were randomly divided into the control group and the observation group,with 56 cases in each group.The control group was given conventional nursing at different phase of ges-tation,and the observation group was applied with continuity midwifery care.The condition of labor pain and anxiety were assessed by visual analog pain scale(VAS)and anxiety visual analog scale(VAS-A).The natural births rate,incidence of fetal distress,postpartum hemorrhage rate,amount of bleeding and duration of labor were observed and compared between two groups.Results:The VAS,VAS-A at 24 h after delivery and amount of bleeding were significant lower in the observation group than those of the control group(P <0.05 or P <0.01 ).There was no significant difference in natural births rate,postpartum hemorrhage rate and incidence of fetal distress between two groups(P >0.05).The duration of first stage of labor,second stage of labor and total stage of labor were significant shorter in the observation group than those of the controls(P <0.05 or P <0.01 ).Conclusion:The continuity of midwifery care is effective in impro-ving negative emotion and reducing the duration of labor and amount of bleeding in puerpera undergoing VBAC delivery.%目的：探讨全程连续性助产护理对剖宫产术后阴道分娩（VBAC）产妇产痛程度及产程的影响。方法：VBAC 产妇112例随机分为对照组和观察组，各56例。对照组采用常规阶段式护理，观察组采用全程连续性助产护理。采用视觉模拟疼痛量表（VAS）和视觉模拟焦虑量表（VAS-A）分别评估两组产痛和焦虑状况；比较两组自然分娩率、胎儿窘迫率、产后出血率、出血量，以及两组中自然分娩产妇的产程。结果：观察组产后24 h 的 VAS 评分、VAS-A 评分及产后出血量显著低于对照组（P ＜0．05或 P ＜0．01）。两组自然分娩率、出血率及胎儿窘迫率无显著差异（P ＞0．05）。观察组第1产程、第2产程及总产程均显著短于对照组（P ＜0．05或 P ＜0．01）。结论：全程连续性助产护理可有效缓解 VBAC 产妇的不良情绪，缩短产程，减少产后出血量。