产前甘油灌肠对产程进展及剖宫产率的影响

欧晓红

[摘要]目的 探讨产前甘油灌肠对产程进展及剖宫产率的影响。方法 选择2007年2月-2008年12月在本科住院分娩的初产妇240例,对照组120例,观察组120例。对照组按常规产科护理,而观察组除按常规产科护理外,排除禁忌证后,初产妇产程进入潜伏期实行清洁灌肠,观察两组产程时间及剖宫产率。结果 观察组120例顺产110例,对照组120例顺产96例;两组产妇第一产程、第二产程及总产程时间比较,经统计学分析,均P<0.01,差异有统计学意义;但第三产程时间比较,经统计学分析,P>0.05,差异无统计学意义。观察组剖宫产10例(8.3%),对照组剖宫产24例(20.0%),P<0.01,差异有统计学意义。结论 产前甘油灌肠能明显缩短产程,避免产时污染,降低剖宫产率,提高产科质量。

[关键词] 产前;甘油灌肠;产程;剖宫产率

[中图分类号] R719.8[文献标识码] A [文章编号] 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

分娩是一种自然生理过程,但由于产妇对分娩缺乏足够的科学认识以及环境改变的影响,产妇往往觉得分娩比想象中的痛苦,多数产妇会产生焦虑、恐惧、依赖性强等心理[1],而焦虑、恐惧可干扰体内儿茶酚胺分泌,从而导致宫缩乏力,产程延长。目前,临床多采用缩宫素和手术方式缩短产程,加速分娩,导致剖宫产率升高。有文献报道[2],某些医院剖宫产率在50%左右。对初产妇实行产前甘油灌肠[3]既可清洁肠道,也可加强宫缩,缩短产程,促进自然分娩,降低剖宫产率。

1资料与方法

1.1一般资料

选取2007年2月-2008年12月在本科住院分娩的120例初产妇,年龄21-32岁,平均(25.0±2.3)岁,孕龄37-42W,平均(39.5±1.0)W。两组产妇胎位均正常,均足月,无头盆不称及异常阴道流血,无内科并发症及宫缩过强等现象。

1.2方法

1.2.1对照组:产妇临产后按产科护理常规护理,应勤听胎心音,严密观察产程进展进况,发现异常及时报告医生,做好心理护理。

1.2.2 观察组:产妇除按对照组的常规护理及心理护理外,凡进入潜伏期,而无先兆流产、头盆不称、阴道流血、妊娠合并心脏病等禁忌证外,实行清洁灌肠。取75ml甘油加入等量温开水,温度为38°C,嘱产妇排尿后取左侧卧位,按灌肠操作常规进行操作,肛管插入7-10cm缓缓注入溶液,待溶液完全流入肠管后缓缓将肛管拔出,然后按住肛门以免药液流出,嘱产妇有便意即解大便。

1.3观察指标

观察两组产妇的产程时间及剖宫产率。

1.4统计学方法

数据采用SPSS10.统计软件包进行处理和分析,计算资料采用X2