摘要
目的探讨自然分娩会阴无保护接生技术的临床应用效果。方法以2014年1月至2015年12月在广西科技大学第一附属医院产科自然分娩的1 228例初产妇为观察对象,根据接生方式不同分为观察组458例和对照组770例。观察组采用会阴无保护接生技术,对照组采用传统保护会阴接生技术。比较两组产妇会阴损伤程度、会阴侧切率、会阴伤口感染率及第二产程时间,产后2 h内出血量,产后24 h会阴疼痛评分,产后下床活动时间,新生儿窒息情况、出生体质量和肩难产情况,产妇住院时间及对会阴无保护接生技术的评价。结果观察组产妇会阴侧切率、会阴伤口感染率、产后2 h内出血量、产后24 h会阴疼痛评分均较对照组低,产妇住院时间较对照组短,差异均有统计学意义(P<0.01或0.05);两组产妇均未发生会阴Ⅲ度裂伤,观察组产妇会阴Ⅱ度裂伤率明显低于对照组,差异有统计学意义(P<0.01);两组产妇会阴Ⅰ度裂伤率比较,差异无统计学意义(P>0.05)。观察组产妇会阴完整率、产后24 h下床活动时间均优于对照组,差异均有统计学意义(P<0.01或<0.05)。两组第二产程时间、新生儿窒息率和出生时体质量比较,差异均无统计学意义(P>0.05)。问卷调查结果显示,观察组产妇对会阴无保护接生技术的评价优于对照组产妇对传统保护会阴接生法的评价,差异有统计学意义(P<0.05)。结论会阴无保护分娩技术能减轻产妇会阴损伤,缩短住院时间,提高产后舒适度,减少医护人员的工作量,无明显不良分娩结局,值得在各级医院推广应用。
Objective To investigate the clinical application effect of unprotected perineal delivery technology in natural childbirth. Methods A total of 1 228 primiparas of natural delivery in the First Affiliated Hospital of Guangxi University of Science and Technology from January 2014 to December 2015 served as the observation subjects and were divided into the observation group （458 cases） and control group （770 cases） according to different delivery modes. The observation group adopted the unpro- tected perineal delivery technology,while the control group adopted the conventional protected perineal delivery technology. The perineal injury degree, episiotomy rates,perineal wound infection rate,time of second stage of labor, hemorrhage amount within postpartum 2 h,perineal pain score at postpartum 24 h,time of postpartum off-bed activities,neonatal asphyxia,birthweight, shoulder dystocia, parturient hospitalization duration and evaluation on unprotected perineal delivery technology were compared between the two groups. Results The episiotomy rate,perineal wound infection rate,hemorrhage amount within postpartum 2 h and perineal pain score at postpartum 24 h in the observation group were lower than those in the control group with statistically significant difference （P〈0.01 or P〈O.05） ;the parturient hospitalization time in the observation group was shorter than that in the control group,the differences were statistically significant （P〈0.01 or P〈0.05 ） ;no third degree perineal laceration occurred in the two groups, the occurrence rate of second degree perineal laceration in the observation group was significantly lower than that in the control group, the difference was statistically significant （P〈0.01 ） ;the occurrence rate of first degree perineal laceration had no statistical difference between the two groups （P〉0.05）. The perineal integrity rate and time of off-bed activities at postpartum 24 h in the observation group were superior to the control group, the difference was statistically significant （P〈0.01or 0.05 ）. The time of second time of labor, neonatal asphyxia occurrence rate and body weight at birth had no statistical difference between the two groups （P〉 0.05 ）. The questionnaire investigation results showed that the evaluation of observation group parturients on unprotected perineal delivery technology was superior to that of the control group parturients on the conventional protected perineal delivery technology, the difference was statistieally significant （P〈0.05 ）. Conclusion The unprotected perineal delivery technology can alleviate the par- turient＇s perineal injury, shortens the hospitalization duration, increases the postpartum comfort level and reduces the working load of medical staff without obviously adverse pregnant outcome, which is worthy of being promoted and applied in all levels of hospitals.
出处
《现代医药卫生》
2016年第20期3109-3112,共4页
Journal of Modern Medicine & Health
基金
2014年广西壮族自治区高等教育教学改革工程项目(2014JGA194)
关键词
接生
产科
产程
第二
分娩
创伤和损伤
会阴
自然分娩
会阴无保护
Delivery,obstetric
Labor stage,second
Parturition
Wounds and injuries
Perineum
Natural childbirth
Unprotected perineum delivery
