头位阴道分娩会阴切开影响因素Logistic回归分析  

Logistic Regression Analysis of Influencing Factors of Episiotomy during Head Position Delivery

作　　者：朱远[1] 王燕君[1] 张爱霞[2] 徐桂华[1] 

机构地区：[1]南京中医药大学护理学院,江苏南京210023 [2]南京医科大学附属妇产医院,江苏南京210000

出　　处：《护理学报》2017年第16期10-13,共4页Journal of Nursing（China）

基　　金：2015江苏省妇幼健康和计划生育生殖健康科研项目(F201530);南京市医学科技发展项目(YKK15157)

摘　　要：目的探讨头位阴道分娩会阴切开影响因素,为减少会阴切开率提供科学依据。方法 2016年9—12月选取我院头位经阴道分娩产妇418例,其中会阴切开189例,会阴撕裂228例,对可能引起会阴切开的13项因素进行单因素分析和Logistic回归分析。结果多因素Logistic回归分析显示:经产是会阴切开的保护因素,胎心变异、会阴条件差、第2产程时间延长、产力异常、产妇配合度差、早产、妊娠合并症及胎头较硬8项因素为会阴切开的危险因素(P<0.05),决定系数R^2为0.651。结论经产妇是会阴切开的保护因素,会阴切开危险因素包括胎心变异、会阴条件、第2产程时间、产力、产妇的配合度、孕周、妊娠合并症及胎头硬度。产程中应加强母儿观察,动态评估产程变化,综合分析,权衡利弊,最大程度降低会阴切开率。Objective To explore the risk factors of episiotomy and to provide scientific basis for reducing episiotomy during delivery. Methods We conducted univariate analysis and logistic regression analysis for 13 risk factors of episiotomy in 418 pregnant women receiving vaginal delivery in 2016 including 189 pregnant women with episiotomy and laceration of perineum 228 cases. Results Multiariable Logistic regression analysis showed that multipara was the protective factor of episiotomy, risk factors included abnormal fetal heartbeat,poor perineal condition, prolonged second stage, abnormality of labor power, poor compliance, premature birth, pregnancy complications and fetal head hardness ,differences were statistical significance （P〈0.05）. the determination coefficient ＂2was 0.651. Conclusion Multipara was the protective factor of episiotomy ,abnormal fetal heartbeat,poor perineal condition, prolonged second stage, Abnormality of labor power, poor compliance, premature birth ,pregnancy complications and fetal head hardness were the risk factors of episiotomy. During delivery,we should strengthen the observation to the mother and fetal, evaluate the process of delivery dynamically,Comprehensive analysis and weigh the advantages and disadvantages to minimizes the episiotomy.

关 键 词：阴道分娩 会阴切开 危险因素 LOGISTIC回归分析 

分 类 号：R473.71[医药卫生—护理学]