双侧阴部神经阻滞麻醉配合保持会阴完整接生在阴道分娩中的应用  

Application of Bilateral Pudendal Nerve Block Anesthesia Combined with Maintaining Complete Perineum Delivery in Vaginal Delivery

作　　者：龚玉亚[1] GONG Yu-ya(Department of Obstetrics, Jiangyin Central Hospital, Jiangyin, Jiangsu Province, 214400 China)

机构地区：[1]江阴市中医院产科

出　　处：《系统医学》2019年第13期156-158,共3页Systems Medicine

摘　　要：目的研究双侧阴部神经阻滞麻醉在阴道分娩中保持会阴完整的临床效应.方法将该院在2016年2月—2018年12月期间收治的产妇94例作为该次研究对象,按照随机数字表法将其分为研究组和对照组,每组47例,对照组采取自然分娩,研究组采取双侧阴部神经阻滞麻醉下阴道分娩,比较两组的产妇的会阴完整性以及会阴裂伤程度,并观察两组新生儿的评分、住院天数以及伤口愈合情况.结果分娩后,研究组会阴完整率为91.49%,显著高于对照组(40.43%)(x^2=27.2903,P<0.05),研究组会阴Ⅰ度裂伤率(6.38%)显著低于对照组(34.04%)(x^2=11.1481,P<0.05),且会阴Ⅱ度裂伤率(2.13%)明显低于对照组(25.53%)(x^2=10.8015,P<0.05),组间差异有统计学意义(P<0.05),两组均无会阴Ⅲ度裂伤情况发生;研究组伤口愈合较好的人数为45例,约占比例为95.74%,显著高于对照组(31例,65.96%),研究组住院天数显著短于对照组(x^2=13.4678,t=13.5434,P<0.05),新生儿评分方面显示:研究组新生儿评分8~10分的有44例,约93.62%,显著高于对照组(32例,68.08%),组间差异有统计学意义(x^2=9.8947).结论阴道分娩中应用双侧阴部神经阻滞麻醉的效果显著,不仅能够顺利完成分娩,还会保持产妇的会阴完整性,且有效降低了会阴裂伤率,一定程度缓解了产妇的伤口疼痛,在提高阴道分娩率方面具有显著优势,值得进一步临床应用与探索.Objective To study the clinical effect of bilateral pudendal nerve block anesthesia to maintain perineal integrity during vaginal delivery. Methods A total of 94 cases of primiparas admitted to our hospital from February 2016 to December 2018 were included in the study. According to the random number table method, they were divided into study group and control group, 47 cases in each group. The control group underwent the natural delivery, while the study group underwent vaginal delivery under bilateral anesthesia with pudendal nerve block. The maternal perineal integrity and degree of perineal laceration were compared between the two groups. The scores of the newborns, hospital stay and wound healing were observed. Results After childbirth, the perineal integrity rate of the study group was 91.49%, which was significantly higher than that of the control group (40.43%)(χ^2=27.290 3,P<0.05). The rate of perineal Ⅰ degree laceration in the study group (6.38%) was significantly lower than that of the control group (34.04%)(χ^2=11.148 1,P<0.05). The rate of perineal Ⅱ degree laceration in the study group (2.13%) was significantly lower than that of the control group (25.53%)(χ^2=10.801 5,P<0.05). There was significant difference between the two groups. There was no perineal Ⅲ degree laceration in the two groups. The number of wound healing in the study group was 45 cases, accounting for 95.74%, which was significantly higher than that of the control group (31 cases, 65.96%). Hospitalization time in the study group was significantly shorter than that in the control group (χ^2=13.467 8,t=13.5434,P<0.05). The neonatal score showed: there were 44 cases (93.62%) in the study group scored 8-10 points, which was significantly higher than that in the control group (32 cases, 68.08%), the difference between the groups was statistically significant (χ^2=9.894 7,P<0.05). Conclusion The effect of bilateral pudendal nerve block anesthesia in vaginal delivery is significant. It not only can successfully complete the del

关 键 词：双侧阴部神经阻滞麻醉 阴道分娩 会阴完整性 新生儿评分 会阴裂伤程度 

分 类 号：R473[医药卫生—护理学]