农村地区自然分娩产妇会阴侧切术影响因素多元回归分析  

Multiple regression analysis on influencing factors of lateral episiotomy of spontaneous labor puerpera in rural areas

作　　者：谢辉[1] 尹学琼[1] Xie Hui Yin Xueqiong(Department of Obstetrics, Chongzhou Maternal ＆ Child Health Hospital ,Sichuan 611230, China)

机构地区：[1]崇州市妇幼保健院产科,四川611230

出　　处：《现代医药卫生》2017年第9期1302-1304,共3页Journal of Modern Medicine & Health

基　　金：四川省教育厅基层卫生事业发展研究项目(SGWF1415);成都市科研基金资助项目(12PPYB096SF-002)

摘　　要：目的探讨影响农村地区自然分娩产妇接受会阴侧切术的影响因素,分析会阴侧切术对产妇及新生儿的影响。方法回顾性分析该院2013年1月至2014年12月经阴道自然分娩患者240例(其中接受及未接受会阴侧切术各120例)的临床资料,采用单因素分析两组患者的年龄、体质量指数、孕周等一般资料,以及孕、产期临床指标及新生儿指标,并对可能影响切口感染的因素进行logistic回归分析。结果单因素分析显示,两组患者年龄、入院时孕周、胎儿体质量、新生儿Apgar评分、孕期并发症、胎儿窒息发生率比较,差异均无统计学意义(P>0.05);而会阴侧切组患者孕前体质量指数、孕期刺激性饮食患者比例、产时出血量均高于未侧切组,膳食指导依从性低于对未侧切组,第二产程时间长于未侧切组,差异均有统计学意义(P<0.05)。logistic回归分析显示,孕前体质量指数、孕期刺激性饮食、膳食指导依从性差、产时出血量、妊娠并发症及第二产程时间是农村地区产妇会阴侧切的危险因素(P<0.05)。结论产妇应加强孕期膳食指导,纠正刺激性饮食习惯,将孕期体质量控制在适宜范围,有助于控制相应危险因素,以降低会阴侧切率。Objective To explore the influencing factors of lateral episiotomy of spontaneous labor puerpera in rural areas,and analyze the influence of lateral episiotomy on the puerpera and the neonatal.Methods Clinical data of 240 puerpera with vaginal delivery,including 120 cases with lateral episiotomy（lateral episiotomy group） and 120 cases without lateral episiotomy（non-lateral episiotomy group）,was analyzed retrospectively from January 2013 to December 2014.Single factor analysis was conducted between the two groups on puerpera′s general information,such as age,body mass index（BMI）,gestational weeks,et al.,pregnant and puer-peral period clinical indicators and neonatal indexes,while the logistic regression analysis was adopted to analyze the influencing factors of incision infection.Results Single factor analysis showed that the incidence rates of puerpera′s age,gestational weeks,the neonatal′ s body mass,Apgar scores,pregnancy complications and fetal asphyxia between the two groups had no statistically significant difference（P〉0.05）,while the progestation BMI,the proportion of spicy diet during pregnancy and bleeding volume during delivery in the lateral episiotomy group were higher than those in the non-lateral episiotomy group,diet guidance compliance was lower than that in the non-lateral episiotomy group and the second stage of labor was longer than that in the non-lateral episiotomy group,the difference had statistical significance（P〈0.05）.The logistic regression showed that progestation BMI,spicy diet during pregnancy,poor compliance of diet guidance,hemorrhage during operation,pregnancy complications and prolonged the second stage of labor were risk factors to literal episiotomy of puerpera in rural areas（P〈0.05）.Conclusion It is helpful to strengthen dietary guidance during preg nancy,break the bad habit of spicy diet and make the body mass in a proper range during pregnancy to control the risk factors and reduce the rate of lateral episiotomy.

关 键 词：会阴切开术 分娩 LOGISTIC模型 危险因素 农村 

分 类 号：R714.3[医药卫生—妇产科学]