產(chǎn)前甘油灌腸對產(chǎn)程進(jìn)展及剖宮產(chǎn)率的影響

歐曉紅

[摘要]目的 探討產(chǎn)前甘油灌腸對產(chǎn)程進(jìn)展及剖宮產(chǎn)率的影響。方法 選擇2007年2月-2008年12月在本科住院分娩的初產(chǎn)婦240例,對照組120例,觀察組120例。對照組按常規(guī)產(chǎn)科護理,而觀察組除按常規(guī)產(chǎn)科護理外,排除禁忌證后,初產(chǎn)婦產(chǎn)程進(jìn)入潛伏期實行清潔灌腸,觀察兩組產(chǎn)程時間及剖宮產(chǎn)率。結(jié)果 觀察組120例順產(chǎn)110例,對照組120例順產(chǎn)96例;兩組產(chǎn)婦第一產(chǎn)程、第二產(chǎn)程及總產(chǎn)程時間比較,經(jīng)統(tǒng)計學(xué)分析,均P<0.01,差異有統(tǒng)計學(xué)意義;但第三產(chǎn)程時間比較,經(jīng)統(tǒng)計學(xué)分析,P>0.05,差異無統(tǒng)計學(xué)意義。觀察組剖宮產(chǎn)10例(8.3%),對照組剖宮產(chǎn)24例(20.0%),P<0.01,差異有統(tǒng)計學(xué)意義。結(jié)論 產(chǎn)前甘油灌腸能明顯縮短產(chǎn)程,避免產(chǎn)時污染,降低剖宮產(chǎn)率,提高產(chǎn)科質(zhì)量。

[關(guān)鍵詞] 產(chǎn)前;甘油灌腸;產(chǎn)程;剖宮產(chǎn)率

[中圖分類號] R719.8[文獻(xiàn)標(biāo)識碼] A [文章編號] 1004-8650(2009)06-108-02

The Effect of Prenatal Glycerine Enema on Labor Progress and Cesarean Section Rate

OU Xiao-hong

(People's Hospital of Luoding, Guangdong, 527200)

[Abstract] Objective To discuss the effect of prenatal glycerine enema on labor progress and cesarean section rate. Methods 240 primipara in our department from Feb. 2007 to Dec. 2008 were divided into control group (120 cases) and observation group (120 cases). Control group was given conventional obstetrical nursing, while treatment group was added cleaning enema after exclusion of contraindication. Two groups'labor time and cesarean section rate were observed. Results 110 cases in observation group and 96 cases in control group got spontaneous delivery. Two groups'time of the first stage of labor, the second stage of labor and total labor had statistical significance, P<0.01. But for the time of the third stage of labor, the difference had no statistical significance, P>0.05.10 (8.3%) cases in observation group and 24 (20.0%) cases in control group got cesarean section, the difference had statistical significance, P<0.01. Conclusion Prenatal glycerine enema can obviously shorten the labor time, avoid pollution during labor, decrease cesarean section rate, and improve the quality of obstetrical department

[Key words] prenatal; glycerine enema; process of labor; cesarean section rate

分娩是一種自然生理過程,但由于產(chǎn)婦對分娩缺乏足夠的科學(xué)認(rèn)識以及環(huán)境改變的影響,產(chǎn)婦往往覺得分娩比想象中的痛苦,多數(shù)產(chǎn)婦會產(chǎn)生焦慮、恐懼、依賴性強等心理[1],而焦慮、恐懼可干擾體內(nèi)兒茶酚胺分泌,從而導(dǎo)致宮縮乏力,產(chǎn)程延長。目前,臨床多采用縮宮素和手術(shù)方式縮短產(chǎn)程,加速分娩,導(dǎo)致剖宮產(chǎn)率升高。有文獻(xiàn)報道[2],某些醫(yī)院剖宮產(chǎn)率在50%左右。對初產(chǎn)婦實行產(chǎn)前甘油灌腸[3]既可清潔腸道,也可加強宮縮,縮短產(chǎn)程,促進(jìn)自然分娩,降低剖宮產(chǎn)率。

1資料與方法

1.1一般資料

選取2007年2月-2008年12月在本科住院分娩的120例初產(chǎn)婦,年齡21-32歲,平均(25.0±2.3)歲,孕齡37-42W,平均(39.5±1.0)W。兩組產(chǎn)婦胎位均正常,均足月,無頭盆不稱及異常陰道流血,無內(nèi)科并發(fā)癥及宮縮過強等現(xiàn)象。

1.2方法

1.2.1對照組:產(chǎn)婦臨產(chǎn)后按產(chǎn)科護理常規(guī)護理,應(yīng)勤聽胎心音,嚴(yán)密觀察產(chǎn)程進(jìn)展進(jìn)況,發(fā)現(xiàn)異常及時報告醫(yī)生,做好心理護理。

1.2.2 觀察組:產(chǎn)婦除按對照組的常規(guī)護理及心理護理外,凡進(jìn)入潛伏期,而無先兆流產(chǎn)、頭盆不稱、陰道流血、妊娠合并心臟病等禁忌證外,實行清潔灌腸。取75ml甘油加入等量溫開水,溫度為38°C,囑產(chǎn)婦排尿后取左側(cè)臥位,按灌腸操作常規(guī)進(jìn)行操作,肛管插入7-10cm緩緩注入溶液,待溶液完全流入腸管后緩緩將肛管拔出,然后按住肛門以免藥液流出,囑產(chǎn)婦有便意即解大便。

1.3觀察指標(biāo)

觀察兩組產(chǎn)婦的產(chǎn)程時間及剖宮產(chǎn)率。

1.4統(tǒng)計學(xué)方法

數(shù)據(jù)采用SPSS10.統(tǒng)計軟件包進(jìn)行處理和分析,計算資料采用X2