導樂自然分娩產時服務模式的臨床效果觀察

[摘要] 目的 探討導樂陪伴分娩對產婦實施人性化產時服務模式，對促進健康分娩和對母嬰預后的影響。降低剖宮產率，保護、促進和支持自然分娩。方法 按知情同意、自主選擇的方法，將本院住院分娩的產婦分為兩組，對照組442例沿用常規產時服務模式，觀察組440例實施導樂自然分娩產時服務模式。結果 觀察組自然分娩率為88.6%，對照組為40.3%;新生兒窒息率觀察組為1.1%，對照組為4.1%;縮宮素使用、硬膜外麻醉鎮痛及人工破膜等產時干預觀察組少于對照組;產婦對醫生、助產士∕導樂員、護士服務質量和分娩環境的滿意度高于對照組，兩組上述各項指標比較，差異均有顯著性意義(均P<0.01)。結論 導樂陪伴分娩產時服務模式能有效改善分娩結局、減少產時醫療干預，促進自然分娩，提升服務質量。

[關鍵詞] 自然分娩;導樂陪伴分娩;剖宮產

[中圖分類號] R714.3[文獻標識碼] A [文章編號] 1004-8650(2009)07-011-03

Clinical Research on Service Model of Promoting Natural Delivery during Labor Process

LI Xin

(The Second People's Hospital of Foshan City，Guangdong foshan 528000 China)

[Abstract] Objective To reduce caesarean section rate，protect，promote and support natural delivery.Methods The inpatiet pregnant women were divided into two groups according to their will:control group(n=442)using the routine service model and observation group(n=440)subject to the promoting natural delivery service model .The delivery outcomes of the two groups were observed and the interference status during labor process，the fellings and satisfaction of the women compared between the two groups.Results The vaginal delivery rate was 93.41%in the observation group and 42.99%in the control group. The neonatal apnea rate was 1.14%in the observation group and 4.07%in the control group. The observation group had an obvious decerease in obstetrical interference measures such as oxytocin induction rate and epidural anesthesia pain relieve rate. The satisfaction about doctors，midwives，nurse and labor environment in the observing group was much higher than in the control group .Comparison between the two groups showed a notably statistical difference(all P<0.01).Conclusion The promoting natral delivery service model can improve delivery outcomes，reduce obstetrical medical interference and can promote natural delivery.It also can improve service quality and gain higher satisfactory rate.

[Key words] natural delivery; doula accompanied delivery; caesarean section

分娩是人類繁衍的基本生理現象，專業化的接生是近代醫學的事[1]。近代醫學服務模式在其發展和演變過程中，一方面很大程度上降低了母嬰死亡率，同時使剖宮產率不斷上升，而導致了一系列母嬰安全問題[2]。為了改變上述狀況，歐洲一些國家自20世紀70年代末期開始進行導樂陪產的研究，并獲得良好效果[3]。隨后我國也有一些導樂陪產的相關報道[4]，本研究以降低剖宮產率、促進自然分娩，提高產時服務質量為直接目的進行產時服務模式的探討?，F將結果報告如下。

1資料與方法

1.1一般資料……