双侧会阴阻滞麻醉在降低会阴侧切率中的应用  

Application of bilateral perineal block anesthesia in reducing lateral perineal incision rate

作　　者：吴小梅[1] 刘文萍[1] 董文姗 WU Xiao-mei;LIU Wen-ping;DONG Wen-shan(Department of Obstetrics and Gynecology, Xingguo County People′s Hospital, Jiangxi Province, Xingguo 342400, China)

机构地区：[1]江西省兴国县人民医院妇产科

出　　处：《中国当代医药》2019年第25期124-126,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2018ZSF634)

摘　　要：目的探讨双侧会阴阻滞麻醉在降低会阴侧切率中的应用效果。方法选取2017年12月~2018年12月我院收治的800例产妇,根据不同镇痛方案将其分为两组,每组各400例。对照组采用单侧会阴阻滞麻醉,观察组在此基础上采用双侧会阴阻滞麻醉,比较两组的会阴损伤程度、会阴侧切率、分娩时疼痛程度、产程、产后盆底肌损伤程度、分娩时和产后24h的出血量。结果观察组的会阴裂伤程度、分娩时的疼痛程度轻于对照组,差异有统计学意义(P<0.05);观察组会阴侧切率为27.25%,低于对照组的39.25%,差异有统计学意义(P<0.05);观察组第二产程短于对照组,差异有统计学意义(P<0.05);观察组分娩时和产后24h的出血量均少于对照组,差异有统计学意义(P<0.05);观察组产妇产后肌力测定级别≥3级者比例为72.25%,高于对照组的61.75%,差异有统计学意义(P<0.05)。结论在产妇分娩中应用双侧会阴阻滞麻醉能有效减轻会阴受损程度、分娩时的疼痛感和盆底损伤,降低会阴侧切率,缩短第二产程,减少分娩和产后出血量,值得推广。Objective To explore the effect of bilateral perineal block anesthesia in reducing the rate of lateral perineal incision rate. Methods A total of 800 parturients admitted to our hospital from December 2017 to December 2018 were selected. According to different analgesic programs, they were divided into two groups, 400 cases in each group. The control group received unilateral perineal block anesthesia. The observation group was treated with bilateral perineal block anesthesia. The degree of perineal injury, the rate of perineal cut, the degree of pain during childbirth, and the stage of labor were compared between the two groups. The degree of postpartum pelvic floor injury, the amount of bleeding at the time of delivery and 24 hours after delivery were compared between the two groups. Results The degree of perineal laceration, the degree of pain during childbirth in the observing group was lighter than those of the control group, the differences were statistically significant (P<0.05). The rate of perineal cut was 27.25%, which was lower than that of the control group 39.25%, the difference was statistically significant (P<0.05). The second stage of labor in the observation group was shorter than that of the control group, the difference was statistically significant (P<0.05). The observation group had less bleeding volume during delivery and 24 hours postpartum than the control group, the differences were statistically significant (P<0.05);the proportion of postpartum muscle strength measurement level ≥3 in the observation group was 72.25%, higher than the control group (61.75%), the difference was statistically significant (P<0.05). Conclusion The use of bilateral perineal block anesthesia in maternal delivery can effectively reduce the degree of perineal damage, pain during childbirth and pelvic floor injury, reduce the rate of perineal cut, shorten the second stage of labor, reduce the amount of delivery and postpartum hemorrhage, it is worth promoting.

关 键 词：双侧会阴阻滞麻醉 会阴侧切 会阴裂伤 疼痛 出血量 

分 类 号：R614[医药卫生—麻醉学]