导乐陪伴分娩在初产妇阴道分娩中的临床应用(1)
摘要：目的 探讨导乐陪伴分娩在初产妇分娩过程中对剖宫产率，无指征剖宫产率、产后出血、新生儿窒息率和患者满意度及纠纷发生的影响。方法 回顾性分析我院2012年～2015年400例阴道分娩的初产妇，将200例实行了导乐陪伴分娩的初产妇作为研究组，200例实行非导乐陪伴分娩的初产妇作为对照组，进行临床对比观察。结果 导乐陪伴分娩组剖宫产率下降(P<0.001)，无指征剖宫国产下降(P<0.05)，产后出血率下降(P<0.05)，新生儿轻度窒息率降低(P<0.05)，患者满意率增加(P<0.01)，减少产科抱怨或投诉(P<0.05)。结论 导乐陪伴分娩能增强初产妇阴道分娩的信心，既能降低剖宫产率，尤其是减少个人要求的剖宫产又能减少产后出血，还能保护产妇和新生儿安全，能增进医护和产妇的沟通，提高产妇及家属满意度，减少医患纠纷，提高产科质量。
关键词：初产妇；分娩；导乐陪伴分娩
Analysis of the Effect of Doula Services for Laboring Women in Early Maternal Vaginal Delivery
, 百拇医药
SHEN Xian-ping1，SHAO Guo-yuan1，ZHANG Heng2
(1.Obstetrics and Gynecology Department，Yichang Maternal and Child Health-Care Hospital，Yichang 443000，Hubei，China；2.Department of Epidemiology and Health Statistics，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430030，Hubei，China)
Abstract：Objective To explore the effects of doula services for laboring women on the incidence of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia， and occurrence of patient satisfaction and disputes. Methods 200 primipara with normal delivery as control group and 200 with doula services for laboring womenas research group in the Maternal and Child Health Hospital of Yichang city during 2012 and 2015 were selected， and we compared the delivery outcomes between the two groups. Results The incidences of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia were lower in the research group than those in the control group， and the satisfaction rate among the patients was higher in the research group with less complaints. Conclusion Doula services for laboring womencan enhance the confidence of pregnant women for vaginal delivery， thus reducing the incidences of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia. In the meanwhile， it can promote doctor-patient communication， reduce doctor-patient disputes， and improve the clinical quality of obstetrics.
, 百拇医药
Key words：Primipara； Delivery； Doula services for laboring women
导乐陪伴分娩是在Doula式分娩基础上，以产妇为中心的护理模式，通过有效的护理管理，提供高质量、适合母婴需要的适宜技术，以减少医源性产科干预，降低剖宫产率、提高自然分娩率，达到母婴安全的产时服务新模式。为了促进自然分娩，保障母婴安康，我院于2010年开展导乐分娩，并逐渐完善流程，总结经验，取得了满意效果，具体报道如下。
1 资料与方法
1.1一般资料 回顾性选择 2012 年 1 月～2015 年 12 月入住我院的 400 例阴道分娩的初产妇，将 200 例实行导乐陪伴分娩的初产妇作为研究，200 例实行非导乐陪伴分娩(传统分娩方式) 的初产妇作为对照组。两组产妇的孕周、 孕次、 年龄及新生儿体重比较，无显著性差异(P>0.05)见表1。胎儿产前超声检查及胎儿监护正常，无任何剖宫产指征。入院时经详细沟通，自愿选择阴道分娩，根据产妇及其家属意见选择导乐陪伴分娩或传统分娩方式。, http://www.100md.com(慎先萍 邵国媛 张恒)
关键词：初产妇；分娩；导乐陪伴分娩
Analysis of the Effect of Doula Services for Laboring Women in Early Maternal Vaginal Delivery
, 百拇医药
SHEN Xian-ping1，SHAO Guo-yuan1，ZHANG Heng2
(1.Obstetrics and Gynecology Department，Yichang Maternal and Child Health-Care Hospital，Yichang 443000，Hubei，China；2.Department of Epidemiology and Health Statistics，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430030，Hubei，China)
Abstract：Objective To explore the effects of doula services for laboring women on the incidence of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia， and occurrence of patient satisfaction and disputes. Methods 200 primipara with normal delivery as control group and 200 with doula services for laboring womenas research group in the Maternal and Child Health Hospital of Yichang city during 2012 and 2015 were selected， and we compared the delivery outcomes between the two groups. Results The incidences of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia were lower in the research group than those in the control group， and the satisfaction rate among the patients was higher in the research group with less complaints. Conclusion Doula services for laboring womencan enhance the confidence of pregnant women for vaginal delivery， thus reducing the incidences of cesarean section， cesarean section without indications， postpartum hemorrhage and neonatal asphyxia. In the meanwhile， it can promote doctor-patient communication， reduce doctor-patient disputes， and improve the clinical quality of obstetrics.
, 百拇医药
Key words：Primipara； Delivery； Doula services for laboring women
导乐陪伴分娩是在Doula式分娩基础上，以产妇为中心的护理模式，通过有效的护理管理，提供高质量、适合母婴需要的适宜技术，以减少医源性产科干预，降低剖宫产率、提高自然分娩率，达到母婴安全的产时服务新模式。为了促进自然分娩，保障母婴安康，我院于2010年开展导乐分娩，并逐渐完善流程，总结经验，取得了满意效果，具体报道如下。
1 资料与方法
1.1一般资料 回顾性选择 2012 年 1 月～2015 年 12 月入住我院的 400 例阴道分娩的初产妇，将 200 例实行导乐陪伴分娩的初产妇作为研究，200 例实行非导乐陪伴分娩(传统分娩方式) 的初产妇作为对照组。两组产妇的孕周、 孕次、 年龄及新生儿体重比较，无显著性差异(P>0.05)见表1。胎儿产前超声检查及胎儿监护正常，无任何剖宫产指征。入院时经详细沟通，自愿选择阴道分娩，根据产妇及其家属意见选择导乐陪伴分娩或传统分娩方式。, http://www.100md.com(慎先萍 邵国媛 张恒)