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[初产妇第二产程中自由体位耳穴压豆联合无保护会阴接生技术的效果]

[Effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the second stage of labor in the primiparas].

作者信息

Yang Guiyan, Chen Qiuzhu, Lin Mingying, Chen Chuihai

机构信息

Department of Gynaecology and Obstetrics, Sanya Maternal and Child Care Service Center, Sanya 572000, Hainan Province, China.

出版信息

Zhongguo Zhen Jiu. 2018 Nov 12;38(11):1171-5. doi: 10.13703/j.0255-2930.2018.11.010.

Abstract

OBJECTIVE

To observe the effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the 2nd stage of labor in the primiparas so as to improve the clinical delivery quality.

METHODS

A total of 146 primiparas who accepted the natural delivery willingly were collected. According to the visit sequence, they were divided into an observation group (72 cases) and a control group (74 cases). The free position and the unprotected perineal delivery were adopted in combination during the labor in both of the two groups. Additionally, in the observation group, the auricular-point pressure with semen vaccariae was intervened when entering the active phase. The points were pengqiang (TF), zigong (uterus), neishengzhiqi (TF), pizhixia (AT), shenmen (TF), jiaogan (AH), pi (CO) and wei (CO). Each point was pressed for 1 to 2 min each time, repeated once every 10 to 20 min until the end of the 2nd stage of labor. The episiotomy rate, perineal laceration degree, perineal pain degree, the duration of the 2nd labor stage, postpartum hemorrhage, postpartum urine retention and neonatal asphyxia rate were recorded and compared in the primiparas between the two groups.

RESULTS

The perineal laceration of the degree Ⅲ and Ⅳ did not occur in the two groups. Compared with the control group, the effect on the perineal laceration was better in the observation group (<0.05). The episiotomy rate was 5.6% (4/72) in the observation group, lower than that in the control group (<0.05). The total perineal laceration rate was 68.1% (48/72) in the observation group, similar to the control group (>0.05). In the observation group, the neonatal asphyxia rate was 1.4% (1/72), the postpartum hemorrhage 6.9% (5/72) and the incidence of urine retention 5.6% (4/72), all lower than 10.8% (8/74), 18.9% (14/74) and 17.6% (13/74) in the control group respectively (all <0.05). In the observation group, on the 1st, 2nd and 3rd days after labor, the perineal pain degree and the duration of the 2nd stage of labor were superior to the control group (all <0.001).

CONCLUSION

The combined therapy of the auricular-point pressure intervention at the free position and the unprotected perineal delivery technique effectively reduces the episiotomy rate and perineal laceration degree, relieves the perineal pain, reduces the neonatal asphyxia rate and improves the delivery quality during the 2nd stage of labor in the primiparas.

摘要

目的

观察初产妇第二产程中自由体位耳穴按压联合会阴无保护接生技术的效果,以提高临床接生质量。

方法

选取146例自愿接受自然分娩的初产妇,按就诊顺序分为观察组(72例)和对照组(74例)。两组产妇分娩时均采用自由体位联合会阴无保护接生。此外,观察组在进入活跃期时采用王不留行籽耳穴按压干预,穴位选取:盆腔(TF)、子宫、内生殖器(TF)、皮质下(AT)、神门(TF)、交感(AH)、脾(CO)、胃(CO)。每次每穴按压1~2分钟,每10~20分钟重复1次,直至第二产程结束。记录并比较两组初产妇的会阴侧切率、会阴裂伤程度、会阴疼痛程度、第二产程时长、产后出血、产后尿潴留及新生儿窒息率。

结果

两组均未发生Ⅲ度及Ⅳ度会阴裂伤。与对照组相比,观察组会阴裂伤效果更好(P<0.05)。观察组会阴侧切率为5.6%(4/72),低于对照组(P<0.05)。观察组会阴总裂伤率为68.1%(48/72),与对照组相近(P>0.05)。观察组新生儿窒息率为1.4%(1/72),产后出血率为6.9%(5/72),尿潴留发生率为5.6%(4/72),均分别低于对照组的10.8%(8/74)、18.9%(14/74)和17.6%(13/74)(均P<0.05)。观察组产后第1、2、3天的会阴疼痛程度及第二产程时长均优于对照组(均P<0.001)。

结论

自由体位耳穴按压干预联合会阴无保护接生技术可有效降低初产妇第二产程的会阴侧切率和会阴裂伤程度,减轻会阴疼痛,降低新生儿窒息率,提高接生质量。

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