阴道分娩后会阴部疼痛的前瞻性观察研究  

A PROSPECTIVE STUDY OF PERINEAL PAIN AFTER VAGINAL DELIVERY

作　　者：王娴[1] 沈洁[1] 冯善武[1] 薛璇[2] 徐世琴[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院麻醉科,南京210029 [2]南京医科大学附属南京市妇幼保健院妇产科,南京210029

出　　处：《中国疼痛医学杂志》2014年第7期490-493,共4页Chinese Journal of Pain Medicine

摘　　要：目的：观察阴道分娩后会阴部疼痛的发生率及严重程度,分析会阴部疼痛的危险因素。方法：随访了306例产妇,采用现实疼痛强度（present pain intensity,PPI）及语言评价量表（verbal rating scale,VRS）评价产后1天及7天的会阴部疼痛情况。分析哪些母体、产科及新生儿因素与产后会阴部疼痛相关。结果：采用PPI评分,产后1天及7天分别有88.2%和24.9%的产妇经历了会阴部疼痛,轻度疼痛比例为63.1%（产后1天）及23.9%（产后7天）,中度疼痛比例为24.2%及1.1%,重度疼痛比例为1%及0%。产后1天及7天,平均VRS评分分别为2（1-3）和0（0-1）。单因素分析中,初产妇、体重指数（body mass index,BMI）高、母体增重多、使用硬膜外镇痛及使用侧切的产妇更易出现会阴部疼痛。多元逻辑回归模型中,只有侧切是产后1天会阴部疼痛的危险因素（相对危险度2.05,95%可信区间0.95-4.42）。结论：产后短期内会阴部疼痛发生率较高但是程度比较轻微,此外,侧切与会阴部疼痛紧密相关。Objective： To explore the incidence and severity of perineal pain after vaginal delivery and assess the risk factors led to perineal pain. Methods： A total of 306 women were followed up and the perineal pain was measured on postpartum day 1 and day 7 with present pain intensity（PPI） and verbal rating scale（VRS）. The correlation between maternal, obstetric, neonatal factors and postpartum perineal pain was assessed. Results： Measured with PPI, 88.2% and 24.9% of women experienced perineal pain on postpartum day 1 and day 7, respectively. Mild pain accounted for 63.1%（day 1） and 23.9%（day 7）, moderate 24.2% and 1.1%, and severe 1% and 0%. Mean VRS for perineal pain was 2（1 - 3） and 0（0 - 1） on postpartum day 1 and day 7, respectively. In univariate analysis, perineal pain was more common among primiparous women, pregnancy with large BMI or maternal weight gain, those with epidural analgesia and those received with episiotomy. In the final multivariate logistic regression model, only episiotomy was a risk factor of perineal pain on postpartum day 1（relative risk 2.05, 95% confidence interval 0.95 - 4.42）. Conclusion： Perineal pain during the short postnatal period was common and slight in our institution. Episiotomy was highly correlated with perineal pain.

关 键 词：侧切 会阴部疼痛 会阴部创伤 

分 类 号：R714.3[医药卫生—妇产科学]