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目的探讨助产士强化沟通模式对产妇分娩应激表现及产程的影响。方法选取2013年6月-2015年4月该院收治的初产妇86例为研究对象,采用随机数表法分为观察组和对照组,各43例。对照组采取常规沟通模式,做好产前检查和孕期指导;观察组在此基础上对沟通环节进行强化,以相关健康教育为主。比较两组产妇配合率,同时观察两组术前与术中焦虑、恐惧程度,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)分析并比较两组应激表现,记录产程时间及产后出血量,比较两组产妇妊娠结局(剖宫产率、产褥感染率、盆腔粘连发生率、母乳喂养率)与新生儿结局(新生儿Apgar评分、体重)。结果观察组配合率(86.0%)明显高于对照组(67.4%),差异有统计学意义(P<0.05);产前观察组SAS评分(56.34±4.16)分、SDS评分(63.24±1.56)分与对照组(56.33±4.15)分、(63.25±1.55)分比较,差异均无统计学意义(均P>0.05);干预后观察组SAS评分(74.30±1.75)分、SDS评分(20.44±3.62)分、产后出血量(251.02±60.41)ml明显低于对照组(89.35±4.20)分、(41.15±1.14)分、(275.38±48.46)ml,差异均有统计学意义(均P<0.05);观察组产程时间(416.26±165.23)min明显短于对照组(497.01±198.43)min,差异有统计学意义(P<0.05);观察组剖宫产率(16.3%)、产褥感染率(4.7%)、盆腔粘连发生率(7.0%)低于对照组34.9%、18.6%、23.2%,差异均有统计学意义(均P<0.05),且其母乳喂养率(86.0%)高于对照组(67.4%),差异有统计学意义(P<0.05);两组新生儿体重(3.14±0.03)kg、(3.16±0.01)kg比较,差异无统计学意义(P>0.05);观察组新生儿出生后5 min、10 min Apgar评分(8.93±1.21)分、(9.85±0.04)分高于对照组(8.54±0.33)分、(9.41±0.02)分,差异均有统计学意义(均P<0.05)。结论助产士强化沟通模式可有效降低产妇分娩应激表现,缩短产程,并改善产妇与新生儿结局,值得在临床推广应用。
Objective To explore the impact of midwifery strengthening communication mode on stress performance and labor process in labor. Methods 86 cases of primipara in our hospital from June 2013 to April 2015 were selected as study object, divided into observation group and control group with 43 cases in each group by random number table. The control group to take the conventional communication mode, prenatal care and prenatal guidance; observation group on the basis of this part of the communication link to strengthen, mainly related to health education. The maternal morbidity rate was compared between the two groups. At the same time, the anxiety and the level of fear before and after operation were observed. SAS and SDS were used to compare and analyze the stress manifestation. Time and postpartum hemorrhage were compared between the two groups. The pregnancy outcomes (cesarean section rate, puerperal infection rate, incidence of pelvic adhesions, breastfeeding rate) and neonatal outcome (neonatal Apgar score, body weight) were compared between the two groups. Results The pre-treatment observation group had significantly higher SAS (56.34 ± 4.16) and SDS (63.24 ± 1.56) compared with the control group (67.4%, P <0.05) There was no significant difference between the control group (56.33 ± 4.15) and (63.25 ± 1.55) points (all P> 0.05). After the intervention, SAS score (74.30 ± 1.75) and SDS score (20.44 ± 3.62), and postpartum hemorrhage (251.02 ± 60.41) ml was significantly lower than that of the control group (89.35 ± 4.20), (41.15 ± 1.14) and (275.38 ± 48.46) ml, respectively ). The labor time in the observation group (416.26 ± 165.23) min was significantly shorter than that in the control group (497.01 ± 198.43) min, the difference was statistically significant (P0.05). The incidence of cesarean section in the observation group (16.3% (P <0.05). The incidence of pelvic adhesions (7.0%) was lower than that of the control group (34.9%, 18.6%, 23.2% The difference between the two groups was statistically significant (P <0.05). There was no significant difference in body weight (3.14 ± 0.03) kg and (3.16 ± 0.01) kg between the two groups (P> 0.05) Group neonatal 5 min after birth, 10 min Apgar score (8.93 ± 1.21) points, (9.85 ± 0.04) points higher than the control group (8.54 ± 0.33) points, (9.41 ± 0.02) points, the differences were statistically significant (P <0.05). Conclusion The midwifery strengthen communication mode can effectively reduce the maternal labor stress performance, shorten the labor process, and improve maternal and neonatal outcomes, it is worth in the clinical application.