半坐卧位结合其它自由体位在分娩中的应用(1)
【摘 要】目的：观察半坐卧位结合其它自由体位对促进产程及自然分娩的效果。方法：选择单活胎，枕先露，无严重并发症合并症孕妇800例，随机分为观察组和对照组，每组各400例，观察组在第一产程采取行走、蹲、坐、卧等自由体位，第二产程采取床头抬高，半坐卧位。对照组采取常规平卧，截石位分娩。观察两组患者三个产程、出血量、试产失败转剖宫产率、胎儿体重及Apgar评分。结果：观察组较对照组产程时间缩短，先露下降快，新生儿评分好，两组比较差异有统计学意义(P<0.01)，转剖宫产率，观察组低于对照组，差异有统计学意义(P<0.05)，出血量，胎儿体重两组无明显差异，无统计学意义(P>0.05)。结论：自由体位分娩可缩短产程，减少母儿并发症，降低剖宫产率，提高产妇舒适度。
【关键词】半坐卧位与自由体位；分娩；应用
Application of Fowler Position and Free Postures in Delivery Zhou Lei， Wang Wenming， Luo Qingping， Du Yuran
Luzhou People’s Hospital of Sichuan， 646000 Luzhou China
[Abstract]Objective： To observe the effect of fowler position and free postures on promoting labor and natural delivery. Methods： Choose 800 cases pregnant women of single birth，occipital presentation and without complication were randomly divided into overview group and control group， and each group had 400 cases.overview group such as walking， squatting， sitting are adopted in the first stage of labor and elevation of head of bed and fowler positon are adopted in the second stage of labor for the observation group. For the control group， traditional prostration and lithotomy position delivery are adopted. Observe the amount of bleeding， cesarean section rate， fetal births weight and Apgar rating of the three stages of the two groups. Result： Observation group is better than control group in terms of labor time， occipital presentation and newborn rating. The comparative difference has statistical significance.(P<0.01). Overview group is lower than the other group in cesarean section rate and the difference has statistical significance(P<0.05). Amout of bleeding： Fetal births weight of the two groups are almost the same without statistical significance(P>0.05). Conclusions： Delivery of free postures can reduce labor time and complications of mothers and babies ，and lower cesarean section rate as well as improve comfort of expectant mothers.
[key words]Fowler position and free position； Labor delivery； Application
分娩本是一个自然过程，随着现代社会环境及医疗环境改变，分娩更多受人为和医疗技术干预，剖宫产率高，自然分娩率低，已成为多数医院的共同点。怎样提高自然分娩率成为医学界广泛关注的问题，我院转变医疗模式，强调妇女在分娩中的主动性和决定作用，采取半坐卧位与自由体位结合分娩方式，让产妇回归自然，取得理想效果，现将方法报告如下：
1 资料与方法
1.1 临床资料 2012年12月至2013年12月我院正常待产的单胎产妇800例，孕周均为37～42周，在分娩前均无妊娠合并症、脐带绕颈、羊水量异常、头盆不称等异常因素。随机分为观察组400例和对照组400例。年龄20～35岁。
1.2 方法 入院后两组待产妇均常规行分娩知识宣教。观察组待产妇以自由体位分娩法进行分娩指导，主要针对第一产程由待产妇自身对体位进行自由选择，以自己感到舒适的体位自由活动。 可选择卧位、慢走、坐、蹲、站立等。同时给予待产妇进行指导及监测。第二产程选择半坐卧位，臀部突出，双脚并拢，膝部尽量弯曲，屏气用力至胎头拨露，准备接产才转为截石位。对照组采取常规体位，即平卧位，分娩时截石位。, 百拇医药(周蕾 王文明 罗庆平 杜雨然)
【关键词】半坐卧位与自由体位；分娩；应用
Application of Fowler Position and Free Postures in Delivery Zhou Lei， Wang Wenming， Luo Qingping， Du Yuran
Luzhou People’s Hospital of Sichuan， 646000 Luzhou China
[Abstract]Objective： To observe the effect of fowler position and free postures on promoting labor and natural delivery. Methods： Choose 800 cases pregnant women of single birth，occipital presentation and without complication were randomly divided into overview group and control group， and each group had 400 cases.overview group such as walking， squatting， sitting are adopted in the first stage of labor and elevation of head of bed and fowler positon are adopted in the second stage of labor for the observation group. For the control group， traditional prostration and lithotomy position delivery are adopted. Observe the amount of bleeding， cesarean section rate， fetal births weight and Apgar rating of the three stages of the two groups. Result： Observation group is better than control group in terms of labor time， occipital presentation and newborn rating. The comparative difference has statistical significance.(P<0.01). Overview group is lower than the other group in cesarean section rate and the difference has statistical significance(P<0.05). Amout of bleeding： Fetal births weight of the two groups are almost the same without statistical significance(P>0.05). Conclusions： Delivery of free postures can reduce labor time and complications of mothers and babies ，and lower cesarean section rate as well as improve comfort of expectant mothers.
[key words]Fowler position and free position； Labor delivery； Application
分娩本是一个自然过程，随着现代社会环境及医疗环境改变，分娩更多受人为和医疗技术干预，剖宫产率高，自然分娩率低，已成为多数医院的共同点。怎样提高自然分娩率成为医学界广泛关注的问题，我院转变医疗模式，强调妇女在分娩中的主动性和决定作用，采取半坐卧位与自由体位结合分娩方式，让产妇回归自然，取得理想效果，现将方法报告如下：
1 资料与方法
1.1 临床资料 2012年12月至2013年12月我院正常待产的单胎产妇800例，孕周均为37～42周，在分娩前均无妊娠合并症、脐带绕颈、羊水量异常、头盆不称等异常因素。随机分为观察组400例和对照组400例。年龄20～35岁。
1.2 方法 入院后两组待产妇均常规行分娩知识宣教。观察组待产妇以自由体位分娩法进行分娩指导，主要针对第一产程由待产妇自身对体位进行自由选择，以自己感到舒适的体位自由活动。 可选择卧位、慢走、坐、蹲、站立等。同时给予待产妇进行指导及监测。第二产程选择半坐卧位，臀部突出，双脚并拢，膝部尽量弯曲，屏气用力至胎头拨露，准备接产才转为截石位。对照组采取常规体位，即平卧位，分娩时截石位。, 百拇医药(周蕾 王文明 罗庆平 杜雨然)