摘要目的:探讨责任制助产护理结合体位管理在初产妇分娩中的应用及对分娩结局的影响。方法:选取2019年1～8月在广州市花都区妇幼保健院进行分娩的初产妇200例，按照简单数字表法分成对照组(100例)和观察组(100例)。对照组产妇予以常规助产护理。观察组产妇则予以责任制助产护理结合体位管理干预。比较两组产妇的分娩结局、产时疼痛程度以及心理状态。结果:观察组产妇的阴道分娩率高于对照组，差异有统计学意义( P<0.05)，而产后并发症发生率低于对照组，差异有统计学意义( P<0.05)；观察组产妇的各产程时间均显著短于对照组，差异有统计学意义( P<0.05)；观察组患者的视觉模拟评分法(VAS)、焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)评分均显著低于对照组，差异有统计学意义( P<0.05)。 结论:在初产妇分娩中采用责任制助产护理结合体位管理，能够有效促进产程进展，缓解分娩疼痛，改善分娩结局及产妇心理状态。

abstractsObjective:To explore the application of responsibility midwifery nursing combined with body position management in primipara delivery and its influence on delivery outcome.Methods:A total of 200 primiparas who delivered in the hospital from January to August 2019 were selected.According to simple number table method, they were divided into control group (100 cases) and observation group (100 cases).The control group was given routine midwifery care.The observation group was given responsibility midwifery nursing combined with position management intervention.The results of delivery, the degree of pain during delivery and the psychological state were compared between the two groups.Results:The vaginal delivery rate of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05), while the incidence of postpartum complications was lower than that of the control group, and the difference was statistically significant ( P<0.05).The duration of each stage of labor in the observation group was significantly shorter than that in the control group, and the difference was statistically significant ( P<0.05).The scores of Visual Analogue Scale(VAS), Self-rating Anxiety Scale(SAS) and Hamilton Anxiety Scale(HAMA) in the observation group were significantly lower than those in the control group, and the differences were statistically signifcant( P<0.05). Conclusions:In the delivery of primipara, the use of responsibility system of midwifery nursing combined with position management can effectively promote the progress of labor, relieve the pain of childbirth, improve the outcome of childbirth and maternal psychological state.