CAJ | 학술논문

目的：探讨分娩球配合自由体位助产对孕产妇心理状态、产痛及分娩控制感的作用。方法选取我院行自然分娩的孕产妇208例，随机法分为对照组和观察组，每组104例。对照组孕产妇实施传统卧位或半卧位待产及分娩，观察组孕产妇实施分娩球配合自由体位助产。采用汉密尔顿焦虑量表（ HAMA）、（ HAMD）评定孕产妇的焦虑、抑郁状况，采用视觉模拟评分法（ VAS）评定孕产妇产痛程度，采用分娩控制量表（ LAS）评定孕产妇分娩控制感。结果分娩后两组孕产妇HAMA评分、HAMD评分均显著降低，观察组孕产妇HAMA、HAMD、VAS评分均明显低于对照组（均P＜0.05），LAS评分明显高于对照组（P＜0.05），孕产妇第一、第二、第三产程及总产程、产后2 h出血量均明显少于对照组（均P＜0.05）。结论分娩球配合自由体位助产可明显改善孕产妇的心理状态，明显减轻孕产妇的产痛，显著提高孕产妇的分娩控制感，值得临床推广使用。
목적：탐토분면구배합자유체위조산대잉산부심리상태、산통급분면공제감적작용。방법선취아원행자연분면적잉산부208례，수궤법분위대조조화관찰조，매조104례。대조조잉산부실시전통와위혹반와위대산급분면，관찰조잉산부실시분면구배합자유체위조산。채용한밀이돈초필량표（ HAMA）、（ HAMD）평정잉산부적초필、억욱상황，채용시각모의평분법（ VAS）평정잉산부산통정도，채용분면공제량표（ LAS）평정잉산부분면공제감。결과분면후량조잉산부HAMA평분、HAMD평분균현저강저，관찰조잉산부HAMA、HAMD、VAS평분균명현저우대조조（균P＜0.05），LAS평분명현고우대조조（P＜0.05），잉산부제일、제이、제삼산정급총산정、산후2 h출혈량균명현소우대조조（균P＜0.05）。결론분면구배합자유체위조산가명현개선잉산부적심리상태，명현감경잉산부적산통，현저제고잉산부적분면공제감，치득림상추엄사용。
Objective To investigate influence of birth ball and free position in psychological status , labor pain and birth control sence of pregnant women.Methods In our hospital from October 2011 to December 2013 , 208 pregnant women were selected who accepted natural childbirth.Pregnant women were randomly divided into two groups.104 pregnant women were treated with traditional supine or semire-cumbent position during pregnancy and delivery as control group.104 pregnant women were treated with birth ball and free position as obser-vation group.Anxiety was evaluated by Hamilton Anxiety Scale ( HAMA ) .Depression was evaluated by Hamilton Depression Scale ( HAMD) .Pain was evaluated by Visual Analogue Scale ( VAS ) .Birth control sence was evaluated by Labor Agentry Scale ( LAS ).Psychological status , labor pain, birth control sence and delivery outcome were compared between two groups.Results After delivery, HA-MA score and HAMD score decreased significantly in two groups.HAMA score, HAMD score, VAS score in observation group were signifi-cantly lower than those in the control group.LAS score in observation group was significantly higher than that in the control group.First stage of labor, second stage of labor, third stage of labor, total labor, postpartum 2h bleeding volume in observation group were significantly less than those in the control group.Differences were statistically significant ( P<0.05 ) .Conclusions Birth ball and free position can signifi-cantly improve psychological status of pregnant women , significantly reduce maternal pain and improve birth control sence.That is worthy of clinical use.