产前低频脉冲联合手法点穴按摩对初产妇分娩及产后泌乳的影响
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摘要
目的探讨产前低频脉冲联合手法点穴按摩对促进初产妇分娩及产后泌乳的临床应用效果。方法选取2017年1月～2018年4月在广西壮族自治区人民医院住院分娩的初产妇120例,按入院待产顺序分为观察组和对照组,每组各60例。对照组按照足月待产常规护理,观察组在对照组基础上进行产前乳房低频脉冲治疗联合穴位按摩,比较两组初产妇宫颈Bishop评分、阴道分娩率、第一产程时间、产后泌乳始动时间、泌乳量、乳汁淤积程度以及乳房舒适度情况。结果两组孕妇的宫颈Bishop评分有随时间不断升高的趋势,且观察组升高的幅度高于对照组(P <0.01)。观察组阴道分娩率高于对照组,第一产程时间及泌乳始动时间较对照组缩短,产后第3、7天泌乳量,产后第3天乳汁淤积程度以及乳房舒适度优于对照组,差异均有统计学意义(P <0.05或P <0.01)。结论产前手法点穴按摩联合低频脉冲对促进宫颈成熟有明显作用,能有效缩短第一产程,提高阴道分娩率;并促进产后早泌乳,增加泌乳量,缓解初产妇乳汁淤积程度,从而增加乳房舒适度。
Objective To explore the clinical application of low-frequency pulse combined with manual acupoint massage in promoting the delivery and postpartum lactation of primipara. Methods One hundred and twenty primparae in the People's Hospital of Guangxi Zhuang Autonomous Region were selected and divided into observation group and control group according to the order of hospitalization, with 60 cases in each group. The control group received routine nursing care according to the term of labor, the observation group was treated with prenatal low-frequency pulse combined with manual acupoint massage on the basis of the control group. The cervical Bishop score, vaginal delivery rate,time of the first period of labor, lactation start time, the volume of postpartum lactation, degree of breast milk deposition and breast comfort level between two groups were compared. Results The cervical Bishop score of the two groups of pregnant women showed a trend of increasing with time, and the increase range in the observation group was higher than that in the control group(P < 0.01). The vaginal delivery rate of observation group was higher than that of the control group; time of the first period of labor and lactation start of observation group was shorter than those of the control group; the volume of postpartum lactation at day 3 and 7, degree of breast milk deposition and breast comfort level at day 3 of observation group were better than those of the control group, the differences were statistically significant(P < 0.05 or P < 0.01). Conclusion Prenatal manual acupoint massage combined with low-frequency pulse has obvious effect on promoting cervical maturation, which can effectively shorten the first delivery period and increase the rate of vaginal delivery. And it can promote early postpartum lactation, which increases the volume of lactation, alleviates the degree of milk siltation of the primipara and thus increases the comfort of the breast.
Objective To explore the clinical application of low-frequency pulse combined with manual acupoint massage in promoting the delivery and postpartum lactation of primipara. Methods One hundred and twenty primparae in the People's Hospital of Guangxi Zhuang Autonomous Region were selected and divided into observation group and control group according to the order of hospitalization, with 60 cases in each group. The control group received routine nursing care according to the term of labor, the observation group was treated with prenatal low-frequency pulse combined with manual acupoint massage on the basis of the control group. The cervical Bishop score, vaginal delivery rate,time of the first period of labor, lactation start time, the volume of postpartum lactation, degree of breast milk deposition and breast comfort level between two groups were compared. Results The cervical Bishop score of the two groups of pregnant women showed a trend of increasing with time, and the increase range in the observation group was higher than that in the control group(P < 0.01). The vaginal delivery rate of observation group was higher than that of the control group; time of the first period of labor and lactation start of observation group was shorter than those of the control group; the volume of postpartum lactation at day 3 and 7, degree of breast milk deposition and breast comfort level at day 3 of observation group were better than those of the control group, the differences were statistically significant(P < 0.05 or P < 0.01). Conclusion Prenatal manual acupoint massage combined with low-frequency pulse has obvious effect on promoting cervical maturation, which can effectively shorten the first delivery period and increase the rate of vaginal delivery. And it can promote early postpartum lactation, which increases the volume of lactation, alleviates the degree of milk siltation of the primipara and thus increases the comfort of the breast.
引文
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[11]罗运静.产后早期实施乳房按摩对产妇泌乳及新生儿生长发育的影响[J].中华现代护理杂志,2011,17(20):2388-2390.
[12]关焕英,林书华,黄菲菲.传统中医促宫颈成熟的应用进展[J].中外女性健康,2014(5):20-21.
[13]李信群,王笑,裘黄飞.乳房穴位按摩结合背部按摩促进产妇乳汁分泌的效果[J].解放军护理杂志,2011,28(9):33-34.
[14]李晓娜.120例过期妊娠病例临床分析[J].中国现代药物应用,2010,4(22):103-104.
[15]史海霞,于芳.促宫颈成熟方法研究进展[J].武警医学,2017,28(8):846-848.
[16]石娟,王彩珊,勇霞,等.针刺昆仑穴位联合拉玛泽呼吸减痛法对初产妇分娩结局的影响[J].现代医院,2017,17(1):117-118.
[17]胡晓燕,谢素萍,胡晓林,等.剖宫产率增高因素及降低措施探讨[J].河北北方学院学报:自然科学版,2014,30(3):89-90,92.
[18]香寰,黄晓丽,陈月兰.剖宫产术后影响母乳喂养的因素分析与护理措施[J].中国当代医药,2017,24(18):166-168.
[19]罗琳雪,韦桂源,方文珠,等.超早期乳房护理干预对母婴分离产妇泌乳影响的研究[J].重庆医学,2012,41(34):3599-3600.
[20]罗玲玲.产后乳房肿胀护理体会[J].中外医学研究,2011,9(9):67-68.
[21]冷丽,郑素平.影响婴儿母乳喂养相关因素临床分析[J]中外医学研究,2011,9(7):91-92.
[22]钱援芳,周月芳,高洋.产前穴位按摩对纯母乳喂养持续时间的影响[J].中华现代护理杂志,2013,19(26):3182-3184.
[23]唐丽珍.5P手法按摩乳房预防剖宫产术后乳汁淤积的临床研究[J].中国医药导报,2018,15(16):174-176.
[24]闻爱群,王丽莉,方方.产后早期按摩热敷对乳汁分泌及乳房肿胀的影响[J].中国医学创新,2012,9(14):107-108.
[2]王冬梅,修文明,佟玲.手法按摩联合低频脉冲治疗乳汁淤积型急性乳腺炎的临床观察[J].中国医药指南,2018,16(7):119-120.
[3]黄远菊.低频电子脉冲治疗仪结合耳穴按压促进剖宫产术后产妇泌乳的效果观察[J].护理学报,2013,20(12):64-66.
[4]张维娜,张俊茹.低频脉冲电治疗法应用于产妇催乳研究及效果评价[J].国际护理学杂志,2012,31(7):1336-1337.
[5]宋伊,张翠娣.穴位按摩对产妇及新生儿临床应用效果的研究进展[J].护士进修杂志,2013,28(17):1559-1561.
[6]毕景芹.穴位按摩对产后乳胀及纯母乳喂养影响的护理体会[J].河北医学,2013,10(12):1141-1143.
[7]Anabusi S,Mei-Dan E,Hallak M,et al.Mechanical labor induction in the obese population:a secondary analysis of a prospective randomized trial[J].Arch Gynecol Obstet,2016,293(1):75-80.
[8]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:177-180.
[9]刘玉玲.低频脉冲治疗对初产妇产后泌乳量和乳房舒适度的影响[J].护理研究,2016,30(18):2290-2292.
[10]陈翠辉,白淑秋.产后早期应用PHENIX治疗仪进行乳房康复干预对产后泌乳的影响[J].中华现代护理杂志,2013,19(17):2080-2082.
[11]罗运静.产后早期实施乳房按摩对产妇泌乳及新生儿生长发育的影响[J].中华现代护理杂志,2011,17(20):2388-2390.
[12]关焕英,林书华,黄菲菲.传统中医促宫颈成熟的应用进展[J].中外女性健康,2014(5):20-21.
[13]李信群,王笑,裘黄飞.乳房穴位按摩结合背部按摩促进产妇乳汁分泌的效果[J].解放军护理杂志,2011,28(9):33-34.
[14]李晓娜.120例过期妊娠病例临床分析[J].中国现代药物应用,2010,4(22):103-104.
[15]史海霞,于芳.促宫颈成熟方法研究进展[J].武警医学,2017,28(8):846-848.
[16]石娟,王彩珊,勇霞,等.针刺昆仑穴位联合拉玛泽呼吸减痛法对初产妇分娩结局的影响[J].现代医院,2017,17(1):117-118.
[17]胡晓燕,谢素萍,胡晓林,等.剖宫产率增高因素及降低措施探讨[J].河北北方学院学报:自然科学版,2014,30(3):89-90,92.
[18]香寰,黄晓丽,陈月兰.剖宫产术后影响母乳喂养的因素分析与护理措施[J].中国当代医药,2017,24(18):166-168.
[19]罗琳雪,韦桂源,方文珠,等.超早期乳房护理干预对母婴分离产妇泌乳影响的研究[J].重庆医学,2012,41(34):3599-3600.
[20]罗玲玲.产后乳房肿胀护理体会[J].中外医学研究,2011,9(9):67-68.
[21]冷丽,郑素平.影响婴儿母乳喂养相关因素临床分析[J]中外医学研究,2011,9(7):91-92.
[22]钱援芳,周月芳,高洋.产前穴位按摩对纯母乳喂养持续时间的影响[J].中华现代护理杂志,2013,19(26):3182-3184.
[23]唐丽珍.5P手法按摩乳房预防剖宫产术后乳汁淤积的临床研究[J].中国医药导报,2018,15(16):174-176.
[24]闻爱群,王丽莉,方方.产后早期按摩热敷对乳汁分泌及乳房肿胀的影响[J].中国医学创新,2012,9(14):107-108.