丈夫陪產(chǎn)配合導(dǎo)樂(lè)陪產(chǎn)應(yīng)用于產(chǎn)婦分娩過(guò)程中對(duì)產(chǎn)程用時(shí)、分娩結(jié)局及滿意度的影響

　　[摘要] 目的 觀察產(chǎn)婦分娩過(guò)程中應(yīng)用丈夫陪產(chǎn)配合導(dǎo)樂(lè)陪產(chǎn)對(duì)產(chǎn)程用時(shí)、分娩結(jié)局及滿意度的影響。 方法 選取2015年7月～2017年7月在我院分娩的128例產(chǎn)婦的臨床資料，按方案不同分為兩組，各64例，對(duì)照組行傳統(tǒng)分娩方式，觀察組行丈夫陪產(chǎn)配合導(dǎo)樂(lè)陪產(chǎn)，比較組間產(chǎn)程、分娩結(jié)局及滿意度。 結(jié)果 觀察組第一、第二、第三產(chǎn)程為（7.35±0.23）h、（0.74±0.05）h、（0.12±0.01）h及總產(chǎn)程（8.23±0.34）h均比對(duì)照組（8.36±0.34）h、（0.96±0.11）h、（0.19±0.02）h、（9.63±0.36）h短（P<0.01）；觀察組自然分娩率（85.94%）比對(duì)照組（53.13%）高，剖宮產(chǎn)率（14.06%）比對(duì)照組（46.89%）低（P<0.01），觀察組產(chǎn)后2 h出血量比對(duì)照組少；觀察組總滿意（93.75%）比對(duì)照組（71.88%）高（P<0.01）。結(jié)論 產(chǎn)婦分娩通過(guò)丈夫陪產(chǎn)聯(lián)合導(dǎo)樂(lè)陪產(chǎn)能顯著縮短產(chǎn)程，提高自然分娩率，減少產(chǎn)后出血，提升滿意度。
　　[關(guān)鍵詞] 產(chǎn)婦分娩；丈夫陪產(chǎn)；導(dǎo)樂(lè)陪產(chǎn)；產(chǎn)程；分娩結(jié)局
　　[中圖分類號(hào)] R714.3 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2018）08-0059-04
　　Effect of delivery accompanied by husband and doula on stage of labor， delivery outcome and satisfaction during labor
　　LIU Zhengjie ZHANG Shengyan
　　Department of Obstetrics and Gynecology， Ruian Maternal and Child Health Care Hospital in Zhejiang Province， Ruian 325200， China
　　[Abstract] Objective To investigate the effects of delivery accompanied by husband and doula on stage of labor， delivery outcome and satisfaction during maternal delivery. Methods The clinical data of 128 puerpera delivering in our hospital from July 2015 to July 2017 were divided into 2 groups with 64 cases in each group. The control group received traditional delivery mode. The observation group used husband accompanied and doula accompanied delivery method. Stage of labor， delivery outcomes and satisfaction were compared between groups. Results The first， second and third stage of labor（7.35±0.23）h，（0.74±0.05） h，（0.12±0.01） h and total stage of labor（8.23±0.34）were shorter compared with the control group （8.36±0.34）h， （0.96±0.11） h，（0.19±0.02）h and（9.63±0.36） h， respectively（P<0.01）. The rate of spontaneous labor in the observation group was 85.94%， which was higher than that in the control group（53.13%）. The rate of cesarean was 14.06%， which was lower than control group （46.89%）（P<0.01）. The amount of 2 h-postpartum hemorrhage in the observation group was less than the control group.The total satisfaction rate of the observation group was 93.75% which was higher than the control group（71.88%）（P<0.01）. Conclusion Maternal delivery accompanied by husband and doula can significantly shorten the stage of labor， increase the rate of spontaneous labor， reduce the postpartum hemorrhage and improve the satisfaction.
　　[Key words] Maternal childbirth； Husband accompanied delivery； Doula accompanied delivery； Stage of labor； Delivery outcome
　　分娩是具有應(yīng)激性的一種生理過(guò)程，產(chǎn)婦是分娩的唯一承受對(duì)象，其在分娩前、分娩中均存在系列情緒變化，例如緊張、害怕、焦急、抑郁等，這種負(fù)面情緒不利于產(chǎn)婦分娩的進(jìn)程，易引起宮縮乏力、宮內(nèi)窘迫等諸多分娩并發(fā)癥，危害母嬰結(jié)局[1]。子宮收縮所引起的陣發(fā)性疼痛是導(dǎo)致產(chǎn)婦分娩期不良情緒變化的主要原因，而分娩引起的恐懼、疼痛則是導(dǎo)致產(chǎn)婦選擇剖宮產(chǎn)分娩的主要因素[2]。產(chǎn)婦在分娩時(shí)感受到的劇烈疼痛使得其肌肉緊繃，抑制血管、子宮進(jìn)行收縮，繼而阻礙分娩進(jìn)程，延緩產(chǎn)程，增加疼痛感，導(dǎo)致妊娠不良結(jié)局[3]。導(dǎo)樂(lè)陪產(chǎn)是近年產(chǎn)科興起的一種新型分娩模式，在分娩全程中予以產(chǎn)婦情感、生理、心理支持，以增強(qiáng)產(chǎn)婦自我效能感，優(yōu)化分娩質(zhì)量的一種手段[4]。以往產(chǎn)婦分娩拒絕一切除醫(yī)護(hù)人員以外的人員進(jìn)入產(chǎn)房，但是，近幾年許多醫(yī)院開始允許丈夫陪產(chǎn)，這對(duì)產(chǎn)婦分娩起到一定的支持作用。為探討丈夫陪產(chǎn)聯(lián)合導(dǎo)樂(lè)陪產(chǎn)的應(yīng)用效果，我院以2015年7月～2017年7月接收的128例產(chǎn)婦作為研究對(duì)象，現(xiàn)報(bào)道如下。

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