CAJ | 학술논문

目的：探讨自由体位配合无痛分娩对初产妇分娩的影响。方法：将主动要求进行无痛分娩而且无禁忌证的初产孕妇50例设为观察组，在第一、二产程采用自由体位，在宫口开2~3 cm 时进行腰麻-硬膜外麻醉（CSEA），选择同等条件而未要求无痛分娩的孕妇50例为对照组，采用传统卧位待产、分娩，对两组进行动态观察。结果：观察组总产程明显缩短，阴道分娩率明显高于对照组，两组镇痛效果比较有明显差异，两组产后2小时出血量、新生儿窒息率无明显差异。结论：自由体位配合无痛分娩可有效减轻初产妇的疼痛，缩短产程，增加阴道分娩率，而且不增加其产后出血量及新生儿窒息率，安全有效，值得在临床上推广应用。
목적：탐토자유체위배합무통분면대초산부분면적영향。방법：장주동요구진행무통분면이차무금기증적초산잉부50례설위관찰조，재제일、이산정채용자유체위，재궁구개2~3 cm 시진행요마-경막외마취（CSEA），선택동등조건이미요구무통분면적잉부50례위대조조，채용전통와위대산、분면，대량조진행동태관찰。결과：관찰조총산정명현축단，음도분면솔명현고우대조조，량조진통효과비교유명현차이，량조산후2소시출혈량、신생인질식솔무명현차이。결론：자유체위배합무통분면가유효감경초산부적동통，축단산정，증가음도분면솔，이차불증가기산후출혈량급신생인질식솔，안전유효，치득재림상상추엄응용。
Objective To investigate the effect of liberal position combined with epidural on delivery for primiparas. Method 50 pri-miparas actively asking for epidural without contraindications were referred to observed group,using liberal position in the first and second stages and conducting combined spinal - epidural anesthesia(CSEA)When the uterine orifice opened 2 ~ 3 cm;50 pregnant women choo-sing the same conditions but not asking for epidural were regarded as control group,using traditional recumbent position for the predelivery and delivery;dynamically observed the two groups. Results The total labor in the observed group was obviously shortened,the vaginal deliv-ery rate was significantly higher than the control group,there was significant difference in the analgesic effect of two groups,but no obvious difference in terms of the amount of postpartum bleeding in first 2 hours and the neonatal asphyxia rate. Conclusion Liberal position com-bined with epidural can effectively ease the pain of primiparas,shorten the laboring process,increase the rate of vaginal births,furthermore it does not increase the amount of postpartum bleeding and the neonatal asphyxia rate,it is safe and effective,so it is worth popularizing and applying on clinic.