CAJ | 학술논문

目的：探讨低危初产妇分娩时影响疼痛感知的环境因素。方法随机选取2013年1-6月在中国医科大学附属盛京医院妇产科分娩的符合条件的低危初产妇283例为调查对象，在产后24~48 h内，由产妇及其看护者填写相关调查表〔包括产妇的一般情况、视觉模拟评分（VAS）量表、分娩时所经历的环境因素〕。结果283例产妇中，151例（53.4%）产妇的疼痛难以忍受的时间为1 h；57例（20.1%）为2 h。229例（80.9%）产妇VAS≥8分。产妇在分娩过程中的平均内诊次数为（6.3±3.1）次，产妇能够承受的平均内诊次数为（4.4±1.7）次。在调查表列出的18项环境因素中，由产妇无序勾选出认为影响自己疼痛感知的因素，发现排第一和第二位的环境因素分别为环境陌生（86.6%，245/283）和内诊疼痛（83.7%，237/283），助产士不耐心（4.9%，14/283）排在最后一位。283例（100.0%）产妇对自己在产程中的表现评价为非常满意和为自己骄傲。181例（64.0%）产妇认为分娩是一个积极的体验，102例（36.0%）产妇认为分娩是一个负性的体验。结论分娩时最能影响初产妇疼痛感知的环境因素为环境陌生和内诊疼痛。为了减少产妇的分娩疼痛，产科工作者应该改善明显影响产妇疼痛感知的环境因素并减少阴道检查的次数，使更多的产妇具有一个积极正面的分娩体验。
목적：탐토저위초산부분면시영향동통감지적배경인소。방법수궤선취2013년1-6월재중국의과대학부속성경의원부산과분면적부합조건적저위초산부283례위조사대상，재산후24~48 h내，유산부급기간호자전사상관조사표〔포괄산부적일반정황、시각모의평분（VAS）량표、분면시소경력적배경인소〕。결과283례산부중，151례（53.4%）산부적동통난이인수적시간위1 h；57례（20.1%）위2 h。229례（80.9%）산부VAS≥8분。산부재분면과정중적평균내진차수위（6.3±3.1）차，산부능구승수적평균내진차수위（4.4±1.7）차。재조사표렬출적18항배경인소중，유산부무서구선출인위영향자기동통감지적인소，발현배제일화제이위적배경인소분별위배경맥생（86.6%，245/283）화내진동통（83.7%，237/283），조산사불내심（4.9%，14/283）배재최후일위。283례（100.0%）산부대자기재산정중적표현평개위비상만의화위자기교오。181례（64.0%）산부인위분면시일개적겁적체험，102례（36.0%）산부인위분면시일개부성적체험。결론분면시최능영향초산부동통감지적배경인소위배경맥생화내진동통。위료감소산부적분면동통，산과공작자응해개선명현영향산부동통감지적배경인소병감소음도검사적차수，사경다적산부구유일개적겁정면적분면체험。
Objective Toinvestigatetheenvironmentalfactorswhicheffectingthepainperceptionoflow-riskprimip-araduringlabor.Methods Atotalof283eligiblelow-riskprimiparawhogavebirthinDepartmentofObstetricsandGynecolo-gy,Shengjing Hospital Affiliated to China Medical University from January to June in 2013,were selected as study subjects. The questionnaires(including general information of puerperae,visual analogue scale and environmental factors during labor)were completedbypuerperaeandtheircaregiverswithin24-48hoursafterlabor.Results Ofthe283cases,thedurationofunbeara-ble pain was 1 h in 151 cases(53. 4%),2 h in 57 cases(20. 1%). 229 cases(80. 9%)had the pain score≥8. The actual mean frequency of vaginal examination was ( 6. 3 ±3. 1 ), the endurable mean frequency of vaginal examination was ( 4. 4±1. 7). A total of 18 environmental factors were listed in questionnaire,puerperae randomly selected factors which effect on the pain perception,the most frequent environmental factors were the unfamiliar environment(86. 6%,245/283)and pain caused by vaginal examination(83. 7%,237/283),the least frequent factor was midwives' impatience(4. 9%,14/283). All the 283 cases(100. 0%)were satisfied with and proud of themselves,181 cases(64. 0%)thought that labor was a positive experi-ence,102cases(36.0%)thoughtthatlaborwasanegativeexperience.℅onclusion Themostrelevantenvironmentalfactors which effect on pain perception of low-risk primipara during labor are unfamiliar environment and pain caused by vaginal exami-nation. Maternity workers should improve the environment factors which effect on the pain perception of puerperae,as well as de-crease the frequency of vaginal examination,which may help parturients have a positive childbirth experience.