345例初产妇无保护会阴接生的临床观察  

Clinical observation of unprotected perineal birth in 345 cases of primipara

作　　者：刘葵[1] 吕海荣[1] 童军艳[1] 

机构地区：[1]西安市第四医院妇产科,陕西西安710004

出　　处：《中国妇幼健康研究》2016年第12期1534-1536,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨无保护会阴接生法临床应用的效果。方法回顾性分析2014年10月至12月在西安市第四医院产科的885例自然分娩的健康初产妇临床资料,分为采用控制胎头娩出速度,无保护会阴分娩的初产妇345例作为观察组,采用传统接生法分娩的初产妇540例作为对照组。比较两组产妇会阴裂伤程度、产时出血量、新生儿窒息、新生儿体重及产妇满意率的差异。结果观察组产妇会阴完整率、Ⅰ度裂伤比率分别为13.04%、77.97%,显著高于对照组,而会阴侧切和Ⅱ度裂伤率显著低于对照组,差异均有统计学意义(χ2值分别为131.09、4.67、127.19、14.18,均P<0.05)。观察组产妇满意度显著高于对照组(χ2=24.74,P<0.05),而产时出血量显著低于对照组(t=-11.91,P<0.05),两组新生儿窒息发生率无显著性差异(χ2=0.06,P>0.05),新生儿体重无显著性差异(t=1.28,P>0.05)。结论无保护会阴接生法可提高初产妇会阴完整率,减轻了产妇会阴损伤的程度,降低会阴侧切率,减少产时出血,无明显的不良分娩结局,提高产妇满意度和助产技术,值得临床推广。Objective To investigate the effect of unprotected perineal birth in clinical applications. Methods A retrospective analysis was conducted on clinical data of 885 cases of natural birth in Fourth Hospital of Xi＇an City from October to December in 2014,and they were divided into observation group（ 345 cases） with the method of controlling fetal head speed and unprotected perineal birth and control group（ 540 cases） with conventional delivery method. Two groups were compared in perineal laceration degree,intrapartum hemorrhage,neonatal asphyxia,neontal weight and maternal satisfaction rate. Results In the observation group the maternal perineal integrity rate andⅠdegree laceration rate was 13. 04% and 77. 97%,respectively,which was obviously higher than that in the control group,while the rate of episiotomy and perineal Ⅱ degree laceration was significantly lower than that in the control group（ χ2value was 131. 09,4. 67,12. 719 and 14. 18,respectively,all P 〈0. 05）. Maternal satisfaction degree of the observation group was significantly higher than that of the control group（ χ2= 24. 74,P 〈0. 05）,but intrapartum hemorrhage volume was significantly lower in the observation group（ t =- 11. 91,P 〈0. 05）. Two groups were not significantly different in neonatal asphyxia rate（ χ2= 0. 06,P 〉0. 05） and neonatal weight（ t = 1. 28,P 〉0. 05）. Conclusion Unprotected perineal birth method can improve perineal integrity rate of primipara,reduce maternal perineal injury degree and episiotomy rate and reduce bleeding in delivery. No obvious adverse birth outcomes are found. It can improve maternal satisfaction degree and midwifery skills,and it is worth clinical promotion.

关 键 词：阴道分娩 无保护会阴接生 传统助产 满意度 

分 类 号：R714.1[医药卫生—妇产科学]