Clinical use of a multifunctional reflective observation stool in midwifery
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摘要:
目的 比较国外引进接产凳和我科多功能可反光观察接产凳进行坐式分娩在临床中的效果。 方法 选择2022年7—12月于杭州市第一人民医院产科分娩的130例低危初产妇为研究对象,依据使用的坐式分娩凳的不同将运用国外引进接产凳坐式分娩的65例产妇设为对照组,运用杭州市第一人民医院产科多功能可反光观察接产凳坐式分娩的65例产妇设为观察组。比较2组产妇的会阴裂伤程度、会阴侧切率、会阴水肿及会阴疼痛程度、第二产程用时、分娩后2 h出血量、分娩方式、分娩后新生儿窒息或新生儿死亡的发生情况、产妇的舒适度以及子宫复旧情况、产褥病率和产后住院时间。 结果 观察组产妇会阴裂伤程度、会阴侧切率明显低于对照组,同时观察组第二产程所用时间明显短于对照组[(33.43±11.26)min vs. (63.56±11.58)min],分娩后2 h出血量少于对照组[(234.42±37.68)mL vs. (265.67±37.99)mL],差异均有统计学意义(均P < 0.05)。观察组新生儿窒息发生率为6.15%(4/65),明显低于对照组的18.46%(12/65),同时观察组产妇子宫复旧情况优于对照组,产褥病发生率低于对照组且产后住院时间较对照组短,差异均有统计学意义(均P < 0.05)。 结论 与国外引进接产凳坐式分娩相比,运用多功能可反光观察接产凳坐式分娩具有保护会阴,减轻会阴疼痛,缩短产程和产后住院时间,促进产妇舒适分娩的优势。 Abstract:Objective Comparison of the clinical effectiveness of foreign-imported birthing stools and our department' s multi-functional reflective observation birthing stool for seated delivery. Methods A retrospective study was conducted on low-risk primiparous women who gave birth at Hangzhou First People' s Hospital from July to December 2022. Based on the different types of birthing stools used, a total of 65 women who underwent seated delivery with foreign-imported birthing stools were assigned to the control group, and another 65 women who underwent seated delivery with the Hangzhou First People' s Hospital multi-functional reflective observation birthing stool were assigned to the experimental group. The degree of perineal tears, episiotomy rate, perineal oedema and pain, duration of second stage of labour, postpartum bleeding within 2 hours, mode of delivery, occurrence of neonatal asphyxia or neonatal death, maternal comfort, uterine involution, puerperal morbidity rate, and length of postpartum hospital stay were compared between the two groups. Results The experimental group, using the multifunctional reflective observation birthing stool had significantly lower rates of perineal laceration and episiotomy than the control group using foreign-imported birthing stools. In addition, the duration of the second stage of labour was significantly shorter in the experimental group [(33.43±11.26) min] than in the control group [(63.56±11.58) min]; The experimental group also had less postpartum bleeding [(234.42±37.68)mL vs. (265.67±37.99)mL], and these differences were statistically significant (all P < 0.05). In addition, the incidence of neonatal asphyxia in the experimental group (6.15%, 4/65) was significantly lower than in the control group (18.46%, 12/65). The experimental group showed better uterine involution than the control group, with a lower incidence of puerperal morbidity and shorter postpartum hospital stay. These differences were statistically significant (all P < 0.05). Conclusion Compared to foreign birthing stools, the use of the multifunctional reflective observation birthing stool for seated delivery offers advantages in protecting against perineal tears and episiotomy, reducing perineal pain, shortening the duration of labour and the length of hospital stay after delivery, thus promoting maternal comfort. -
Key words:
- Sitting delivery /
- Delivery stool /
- Multi-functional reflective /
- Value in use
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表 1 2组产妇一般资料比较(x±s)
Table 1. Comparison of general information between 2 groups in parturients(x±s)
组别 例数 年龄(岁) 孕周(周) 身高(cm) 体重(kg) 对照组 65 29.76±2.32 39.83±2.98 158.11±6.57 61.51±7.12 观察组 65 30.62±3.61 40.84±1.76 156.43±8.26 62.21±8.12 t值 1.616 2.353 1.283 0.523 P值 0.109 0.020 0.202 0.602 表 2 2组产妇会阴裂伤程度比较[例(%)]
Table 2. Comparison of perineal laceration degrees between two groups of parturients [cases(%)]
组别 例数 会阴裂伤程度 会阴侧切 无裂伤 Ⅰ度 Ⅱ度 Ⅲ度 Ⅳ度 对照组 65 6(9.23) 27(41.54) 32(49.23) 0 0 21(32.31) 观察组 65 15(23.08) 39(60.00) 11(16.92) 0 0 9(13.85) 统计量 3.928a 6.240b P值 < 0.001 0.012 注:a为Z值,b为χ2值。 表 3 2组产妇会阴水肿及会阴疼痛程度比较[例(%)]
Table 3. Comparison of perineal edema and perineal pain between two groups of parturients [cases(%)]
组别 例数 会阴水肿 会阴疼痛 0度 轻度 中重度 0级 Ⅰ级 Ⅱ级 对照组 65 34(52.31) 22(33.85) 9(13.85) 25(38.46) 32(49.23) 8(12.31) 观察组 65 49(75.38) 14(21.54) 2(3.08) 52(80.00) 11(16.92) 2(3.08) Z值 2.470 4.765 P值 0.013 < 0.001 表 4 2组产妇第二产程用时、分娩后2 h出血量以及分娩方式的比较
Table 4. Comparing the duration of the second stage of labor, post-delivery bleeding at 2 hours, and mode of delivery between two groups of parturients
组别 例数 第二产程用时
(x±s, min)分娩后2 h出血量
(x±s, mL)分娩方式[例(%)] 自然分娩 阴道顺产 阴道助产 剖宫产 对照组 65 63.56±11.58 265.67±37.99 30(46.15) 26(40.00) 9(13.85) 56(86.15) 观察组 65 33.43±11.26 234.42±37.68 48(73.84) 15(23.08) 2(3.08) 63(96.92) 统计量 15.039a 4.709a 11.560b 4.866b P值 < 0.001 < 0.001 0.003 0.027 注:a为t值,b为χ2值。 表 5 2组产妇分娩后新生儿窒息或新生儿死亡发生情况比较[例(%)]
Table 5. Comparing the degree of perineal tear between the two groups of parturients
组别 例数 新生儿窒息 新生儿死亡 合计 对照组 65 12(18.46) 1(1.54) 13(20.00) 观察组 65 4(6.15) 0 4(6.15) χ2值 4.561 5.482 P值 0.033 0.999a 0.019 注:a为采用Fisher精确检验。 表 6 2组产妇子宫复旧情况、产褥病发生率及产后住院时间比较
Table 6. Comparing uterine involvement, incidence of puerperal disease, and postpartum hospital stay between the two groups of parturients
组别 例数 子宫复旧情况[例(%)] 产褥病
[例(%)]产后住院时间
(x±s, d)不全 良好 对照组 65 15(23.08) 50(76.92) 26(40.00) 4.13±0.42 观察组 65 6(9.22) 59(90.78) 12(18.46) 2.36±0.36 统计量 4.600a 7.288a 25.797b P值 0.032 0.007 < 0.001 注:a为χ2值,b为t值。 -
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