分娩前干预对会阴保护结局的影响  

Effect of antepartum intervention on outcome of perineal protection

作　　者：郑颖[1] 马秀娟[1] ZHENG Ying MA Xiu-Juan(Department of Obstetrics, the Ninth People＇s Hospital of Chongqing, Chongqing, 400700, Chin)

机构地区：[1]重庆市第九人民医院产科,重庆400700

出　　处：《中国妇幼保健》2017年第20期4914-4916,共3页Maternal and Child Health Care of China

基　　金：重庆市北碚区集成示范计划项目(2014-31)

摘　　要：目的探讨分娩前干预对产妇会阴保护结局的影响。方法将355例孕妇随机分为干预组259例和对照组96例,干预组再分为干预1、2、3组:干预1组90例从孕20周开始行规范的盆底肌肉锻炼Kegel训练,干预2组84例行产前会阴按摩,干预3组85例行规范的盆底肌肉锻炼+产前会阴按摩。对4组孕妇在分娩后会阴完整性、会阴侧切率、器械助产率、产后出血量、会阴水肿、切口或伤口感染、产后尿潴留发生率进行对比分析。结果干预2组能有效降低会阴裂伤发生率,而干预3组会阴裂伤率最低并且会阴裂伤的程度亦最轻;干预1组能有效降低会阴侧切率;干预2组产后会阴水肿发生率较干预1组和干预3组高;不同分娩前干预方式产妇的器械助产率、产后出血量、会阴切口或伤口感染的发生率差异均无统计学意义(P>0.05)。结论孕期行盆底肌肉Kegel训练和产前会阴按摩能有效降低产妇的会阴损伤及会阴侧切率,减轻会阴水肿,联合使用孕期盆底肌肉Kegel训练和产前会阴按摩两种干预方式效果会更加显著。Objective To explore the effect of antepartum intervention on outcome of perineal protection. Methods A total of 355 pregnant women were randomly divided into intervention group （259 pregnant women） and control group （96 pregnant women）, and the pregnant women in intervention group were divided into intervention one group, intervention two group, and intervention three group. Ninety pregnant women in intervention one group underwent Kegel training of pelvic floor muscle exercise from the beginning of the 20th gestational week, 84 pregnant women in intervention two group were treated with prenatal perineal massage, and 85 pregnant women in intervention three group were treated with standard pelvic floor muscle exercise and prenatal perineal massage. The rates of complete perineum, lateral episioto- my, instrumental midwifery, postpartum hemorrhage volumes, the incidence rates of perineal edema, incision or wound infection, and post- partum urinary retention after delivery in the four groups were compared. Results The incidence rate of perineal laceration in intervention two group decreased effectively; the incidence rate of perineal laceration in intervention three group was the lowest, and the degree of perineal laceration was the mildest; the rate of lateral episiotomy in intervention one group decreased effectively ; the incidence rate of perineal edema after delivery in intervention two group was higher than those in intervention one group and intervention three group. There was no statistically significant difference in instrumental midwifery rate, postpartum hemorrhage volume, the incidence rate of incision or wound infection among the pregnant women treated by different antepartum intervention modes （P〉0. 05） . Conclusion Kegel training of pelvic floor muscle exer- cise and prenatal perineal massage can effectively reduce perineal laceration and lateral episiotomy rate, and relieve perineum edema. The effect of combined use of Kegel training of pelvic floor muscle exercise and prenatal perinea

关 键 词：盆底肌肉训练 会阴按摩 会阴保护结局 

分 类 号：R714.3[医药卫生—妇产科学]