改良麻醉方法在会阴切口缝合术中的应用效果  

Application effects of improved anesthetic methods in perineum incision suture

作　　者：李悦[1] 

机构地区：[1]首都医科大学附属北京妇产医院分娩室,100026

出　　处：《中华现代护理杂志》2015年第25期3043-3045,共3页Chinese Journal of Modern Nursing

摘　　要：目的：探讨对经阴道分娩的产妇改良麻醉方法的临床应用效果。方法选择足月单胎经阴道分娩的初产妇400例,会阴部均有侧切或自然裂伤,按照随机数字表法随机分为观察组和对照组。观察组采用新改良麻醉方法,缝合时增加应用1%利多卡因局部浸润麻醉,加强麻醉效果。对照组采用传统方法行阴部神经阻滞加局部浸润麻醉。两组产妇的产后护理和治疗方法相同。比较各组产妇与助产士的配合度、缝合会阴切口时麻醉镇痛效果、产后2h镇痛效果、产后6h尿潴溜发生率、会阴愈合情况。结果观察组产妇缝合时100%（200/200）与助产士配合,对照组产妇83.0%（166/200）可以配合,差异有统计学意义（χ^2=37.158,P〈0.01）。观察组产妇缝合时、产后2 h的镇痛效果、会阴切口愈合情况均优于对照组,差异有统计学意义（Z值分别为-2.231,-2.190,-2.629；P〈0.05）。产后6 h观察组产妇产后尿潴留发生率为1.5%（3/200）,低于对照组的10.0%（20/200）,差异有统计学意义（χ^2=13.332,P〈0.01）。结论改良麻醉方法镇痛效果明显优于传统方法,减轻产妇痛苦,且符合产妇生理、心理需求。Objective To investigate the vaginal delivery women used the improved anesthesia method and explore its clinical effects. Methods A total of 400 primipara with vaginal mature delivery, who had lateral episiotomy and natural laceration, were divided into observation group and control group. The patients of observation group were utilized the new improved methods （ increase 1% lidocaine local infiltration to strengthen the effects of anesthesia） , while the patients of control group received traditional method （ perineal nerve block combined with local infiltration of anesthesia） . The postnatal care and treatment were the same in two groups. We compared the cooperation of puerpera and midwife, anesthesia effects of episiotomy suture, anesthesia effect 2 h after labor, incidence of uroschesis 6 h after labor, and perineal recovery status. Results A total of 100%of puerperas cooperated suture with midwife in the observation group while this number was 83. 0% in the control group （χ^2 =37. 158,P〈0. 01）. Puerpera suture, anesthesia effect after delivery, recovery of perineum incision in the observation group were better than those of the control group （ Z= -2. 231, -2. 190, -2. 629;P〈0. 05）. The incidence of uroschesis 6h after delivery was 1. 5% （3/200） in the observation group lower than 10. 0% （20/200） in the control group （χ^2 =13. 332,P〈0. 01）. Conclusions The improved anesthesia effect is easy to manipulate and better than the traditional method, reduce the pain of puerpera, and is in according with the puerpera′s physiological and psychological demand.

关 键 词：分娩 镇痛 尿潴留 会阴切口缝合 切口愈合 

分 类 号：R472[医药卫生—护理学]