改良阴部神经麻醉联合无保护助产在初产妇自然分娩中的应用  

Application of the modified pudendal nerve anesthesia combined with unprotected midwifery in primiparas undergoing spontaneous delivery

作　　者：刘兰萍[1] 陈久红[1] 嵇曹 朱骏[1] 

机构地区：[1]江苏大学附属医院,江苏镇江212001

出　　处：《齐鲁护理杂志》2016年第18期1-3,共3页Journal of Qilu Nursing

基　　金：镇江市科技支撑计划-社会发展项目(编号:SH2014038)

摘　　要：目的:探讨改良阴部神经麻醉联合无保护助产在初产妇自然分娩中的应用效果。方法:将300例自然分娩的初产妇随机分为观察组和对照组各150例,对照组采用常规阴部神经阻滞麻醉下无保护会阴助产术,观察组采用改良阴部神经阻滞麻醉加外阴多点局部浸润麻醉联合会阴无保护助产术,比较两组会阴损伤指标、产时会阴疼痛、第二产程时间、产后出血、新生儿窒息以及住院时间和住院费用。结果:观察组会阴裂伤率低于对照组(P<0.05),会阴侧切率低于对照组(P<0.05),会阴完整率高于对照组(P<0.05),产时2级会阴疼痛率低于对照组(P<0.05);两组第二产程时间、产后出血、新生儿窒息、住院时间和住院费用比较差异均无统计学意义(P>0.05)。结论:改良阴部神经麻醉联合无保护会阴助产术能降低产妇会阴损伤率和会阴侧切率,提高会阴完整率,减轻产妇会阴疼痛,操作安全、有效。Objective：To investigate the effect of applying the modified pudendal nerve anesthesia combined with unprotected midwifery in primiparas undergoing spontaneous delivery.Methods：300 primiparas with natural childbirth were randomly divided into the observation group and the control group（150 primiparas in each group） .The unprotected midwifery under conventional pudendal nerve anesthesia was used in the control group;the modified pudendal nerve anesthesia plus multipoint local anesthesia combined with unprotected midwifery was adopted in the observation group,the index of perineal injury,perineal pain during labor,the labor time of the second stage,postpartum hemorrhage,neonatal asphyxia,hospitalization time and costs were compared between the two groups.Results：The rate of perineal lacera-tion was lower in the observation group than the control group（P〈0.05）;the perineotomy rate was lower than the control group（P〈0.05）;the perineal integrity rate was higher than the control group（P〈0.05）;the second degree perineal pain rate during labor was lower than the control group（P〈0.05）;there were not statistically significant differences in the comparison of the labor time of the second stage,postpartum hemorrhage,neonatal asphyxia,the hospitalization time and cost between the two groups（P〉0.05）.Conclusion：Applica-tion of the modified pudendal nerve anesthesia combined with unprotected midwifery in primiparas undergoing spontaneous delivery can re-duce maternal perineal injury rate and perineotomy rate,improve the perineal integrity rate and reduce maternal perineal pain,it is safe and effective.

关 键 词：阴部神经麻醉 无保护助产 初产妇 自然分娩 护理 

分 类 号：R473.71[医药卫生—护理学]