自然分娩中会阴无保护接生技术母婴结局的病例对照研究  

Maternal-infant Outcome in Natural Delivery without Perineum Protection:A Case-control Study

作　　者：李晓瑞[1] 姚琴[1] 朱丽红[1] LI Xiao-rui YAO Qin ZHU Li-hong(People＇s Hospital of Xinjiang Uygur A utonomous Region, Urumqi 830000, Chin)

机构地区：[1]新疆自治区人民医院,新疆乌鲁木齐830000

出　　处：《护理学报》2016年第21期5-8,共4页Journal of Nursing（China）

基　　金：新疆维吾尔自治区面向农村和城市社区适宜技术推广项目(TG-201411)

摘　　要：目的探讨自然分娩中会阴无保护接生技术在母婴结局中的效果,推广会阴无保护接生技术在自然分娩中合理使用。方法选取我院2012年6月—2015年6月住院分娩的1519例产妇进行回顾性分析,其中观察组产妇实施会阴无保护接生技术法661例,对照组产妇采用常规接生技术法858例,对产时及产后母婴结局进行对比分析。结果自然分娩中会阴无保护接生技术组的产妇产后出血量少于常规接生技术组,差异有统计学意义（t=6.44,P〈0.001）。自然分娩中会阴无保护接生技术组侧切率为20.5%（136/661）,常规接生技术组为46.4%（398/858）,差异有统计学意义（χ^2=109.12,P〈0.001）;2组产妇均未出现会阴Ⅲ度及以上裂伤,自然分娩中会阴无保护接生技术组产妇会阴完整率、会阴Ⅰ度裂伤率、Ⅱ度裂伤率分别为16.6%（87/525）、82.3%（432/525）、1.1%（6/525）,常规接生技术组分别为4.8%（22/460）、92.2%（424/460）、3.0%（14/460）,会阴无保护接生技术组会阴裂伤程度明显低于常规接生技术组,差异有统计学意义（Z=37.63,P〈0.01）。自然分娩中会阴无保护接生技术组产妇产程时间与常规接生技术组比较差异均无统计学意义（P〉0.05）。自然分娩中会阴无保护接生技术组发生新生儿窒息13例,常规接生技术组发生新生儿窒息33例,差异无统计学意义（χ^2=1.07,P=0.30）。结论自然分娩中开展会阴无保护接生技术,可降低产后出血、会阴侧切率,减轻会阴损伤程度,产妇损伤小,有利于产妇恢复,促进自然分娩,具有积极的临床应用价值。Objective To explore the effect of natural delivery without perineum protection on maternal-infant outcome and to promote the implementation of natural delivery without perineum protection.Methods A retrospective analysis of 1,519 puerperae from June2012 to June 2015 was conducted.A total of 661 cases in observation group had natural delivery without perineum protection while 858 of those in control group routine natural delivery.Maternal-infant outcome in both groups were compared.Results There was less amount of postpartum hemorrhage in observation group when compared with control group and the difference was statistically significant（t=6.44,P〈0.001）.The incidence of episiotomy in observation group was 20.5%（136/661）,which was lower than that in control group of46.4%（398/858） and the difference was statistically significant（χ^2=109.12,P〈0.001）.No occurrence of third-degree perineal laceration was found in both groups.Perinaeum integrity and the incidence of first-degree and second-degree perineal laceration in observation group were 16.6%（87/525）,82.3%（432/525）,and 1.1%（6/525） respectively and those in control group were 4.8%（22/460）,92.2%（424/460） and 3.0%（14/460）respectively.There was significantly less perineal laceration in observation group（Z=37.63,P〈0.01）.Thirteen cases of neonatal asphyxia were found in observation group and 33 in control group,which had no statistical significance（χ^2=1.07,P=0.30）.Conclusion Natural delivery without perineum protection benefits reducing postpartum hemorrhage,episiotomy incidence and perineal laceration thus it promotes the recovery of puerpera,which is worth to be popularized clinically.

关 键 词：自然分娩 会阴无保护接生技术 母婴结局 会阴侧切 

分 类 号：R473.71[医药卫生—护理学]