第二产程会阴热敷对会阴损伤及疼痛的影响  

Effect of perineal hot compress during the second stage of labor on perineal trauma and pain

作　　者：李一美[1] 王小梅[1] 谢爱兰[1] 

机构地区：[1]温州医科大学附属第二医院产科,浙江温州325000

出　　处：《中国妇幼保健》2017年第23期6012-6014,共3页Maternal and Child Health Care of China

基　　金：温州市科技局项目(Y20140185)

摘　　要：目的探讨第二产程会阴热敷对会阴疼痛及损伤的影响。方法选择2014年11月-2016年5月在温州医科大学附属第二医院产科正常足月头位符合阴道分娩的初产妇,按照随机原则分为观察组267例和对照组275例,观察组在胎头拨露、产妇感觉会阴伸展时,用温热生理盐水纱布湿敷并按摩会阴部,对照组采取常规护理方法。观察两组第二产程会阴疼痛程度、会阴损伤、产后会阴疼痛及水肿、产后尿失禁情况。结果观察组第二产程会阴疼痛及会阴损伤较对照组轻,差异有统计学意义(P<0.05);产后第1、2天会阴疼痛及产后会阴水肿程度比较,观察组比对照组轻,差异均有统计学意义(均P<0.05);两组产后42 d及3个月尿失禁发生率比较,差异无统计学意义(P>0.05)。结论第二产程会阴热敷可以减轻会阴疼痛和损伤,提高产时护理质量,减轻产妇痛苦。Objective To explore the effect of perineal hot compress during the second stage of labor on perinea] trauma and pain, Methods The primiparous women meeting the indications of vaginal delivery （normal, full-term, fetal presentation） gave birth to their babies in Department of Obstetrics in the Second Affiliated Hospital of Wenzbou Medical University from November 2014 to May 2016, then they were selected and divided into observation group （267 primiparous women） and control group （275 primiparous women） according to random principle. The primiparous women in observation group were treated by hydropathic compress of warm saline gauze and perineal massage during head visible on vulval gapping and perineum extension; and the primiparous women in control group were treated by routine nurs- ing care. The degrees of perineal pain during the second stage of labor, perineal injury, postpartum perineal pain and edema, postpartum urinary incontinence in the two groups were observed. Results The degrees of perineal pain during the second stage of labor and perineal injury in observation group were statistically significantly milder than those in eontrol group （ P〈0. 05） . The degrees of perineal pain on the first day and the second day after delivery and postpartum perineal edema in observation group were statistically significantly milder than those in control group （ P〈0. 05 ） . There was no statistically significant difference in the incidence rates of postpartum urinary incontinence at 42 days and 3 months after delivery between the two groups （ P〉0. 05 ） . Conclusion Perineal hydropathic compress of warm saline gauze during the second stage of labor can reduce perineal pain and injury, improve the quality of intrapartum nursing, and relieve maternal pain.

关 键 词：第二产程 会阴 热敷 疼痛 损伤 

分 类 号：R714[医药卫生—妇产科学]