目的　探讨实施以人为本 ,以循证医学为指导的人性化产时服务模式、促进健康分娩的可行性 ,并评价该模式对母婴预后的影响。方法　从 2 0 0 0年 11月～ 2 0 0 1年 6月 ,在全国 6个城市 9所医院进行多中心前瞻性随机对照实验 ,将决定阴道分娩的 6 75 8例产妇随机分为研究组 (3437例 )和对照组 (332 1例 )。研究组实施全产程 (从临产到第四产程结束 )陪产。按WHO推荐的常用适宜技术 ,对产妇进行生理、心理、体力的全面支持 ,对照组按常规处理。分娩次日由专人填写调查问卷。结果　研究组自然分娩率为 85 5 % ,明显高于对照组的 6 6 0 % ,差异有极显著性 (P <0 0 1) ,研究组剖宫产率为 8 1% ,明显低于对照组的 2 8 6 % ,差异也有极显著性 (P <0 0 1)。研究组产后出血率、新生儿窒息发生率、新生儿病率明显低于对照组 (P <0 0 5 )。研究组产妇产程中精神紧张、担心、害怕的程度 ,比对照组明显减轻 (P <0 0 1) ,而精神放松及配合产程者明显多于对照组。结论　适宜的产时服务模式 ,可降低剖宫产率、增加自然分娩率及改善母婴预后 Objective To explore the implementation of human-centered, evidence-based medicine as the guidance of the human-centered delivery service model to promote the feasibility of healthy delivery, and evaluate the impact of this model on the prognosis of mothers and children. Methods From November 2000 to June 2001, a multicenter prospective randomized controlled trial was conducted in 9 hospitals in 6 cities across the country. A total of 6 758 women who were scheduled for vaginal delivery were randomly assigned to study group (3437 cases) and control group (332 cases). The research team implemented full-time (from the end of labor to the end of the fourth) paternity. According to the WHO recommended the commonly used appropriate technology, maternal physical, psychological, physical comprehensive support, the control group according to conventional treatment. The next day delivery by hand to complete the questionnaire. Results The rate of natural childbirth in the study group was 85.5%, which was significantly higher than that in the control group (P <0.01). The cesarean section rate in the study group was 81%, which was significantly lower than that in the control group There was also a significant difference between the two groups (P <0.01). Postpartum hemorrhage, neonatal asphyxia and neonatal morbidity in the study group were significantly lower than those in the control group (P <0.05). In the study group, the degree of stress, fear and fear in the labor process was significantly lower than that in the control group (P <0.01). However, the patients in the study group were significantly more mentally relaxed than those in the control group. Conclusions The appropriate mode of delivery service can reduce the rate of cesarean section, increase the rate of natural delivery and improve the prognosis of maternal and infant