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 Perineum Incision in Head Vaginal Delivery

作　　者：陈红珍 CHEN Hongzhen(Lishui Branch,Zhongda Hospital Affiliated to Southeast University,Nanjing 211200,China)

机构地区：[1]东南大学附属中大医院溧水分院,江苏南京211200

出　　处：《中外医学研究》2021年第1期35-37,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：南京市卫生科技发展专项资金项目(YKK18217);南京市医学科技发展资金项目(QRX17112)。

摘　　要：目的:探讨头位阴道分娩会阴切开影响因素,为降低会阴切开率提供循证依据。方法:收集2019年1-6月在本院行头位阴道分娩产妇400例,其中会阴切开分娩200例,自然分娩200例,对可能引起会阴切开的14项因素进行单因素分析,将单因素分析得出的有统计学意义的因素进行Logistic回归分析。结果:单因素分析共筛选出产次、羊水性状、分娩镇痛、第二产程时间、胎心变异、妊娠期高血压疾病、会阴条件、肩难产、胎头吸引共9项相关因素,Logistic回归分析确定经产为会阴切开的保护因素,羊水性状、第二产程时间延长、肩难产为会阴切开的危险因素(P<0.05)。结论:分娩中应加强对羊水性状的观察,密切关注第二产程进展,提高助产技巧以减少肩难产,避免常规行会阴切开,维护产妇会阴完整性。Objective:To explore the influencing factors of perineum incision in head vaginal delivery,and to provide evidence-based basis for reducing perineum incision rate.Method:From January to June 2019,400 parturients undergoing vaginal delivery in head position in our hospital were collected,including 200 cases of perineum incision delivery and 200 cases of natural delivery.The 14 factors that may cause perineum incision were analyzed by univariate analysis.Logistic regression analysis was performed on the statistically significant factors obtained from univariate analysis.Result:Single factor analysis screened 9 related factors,including parity,amniotic fluid properties,labor analgesia,time of the second stage of labor,fetal heart rate variation,hypertensive disorder complicating pregnancy,perineal condition,shoulder dystocia and fetal head attraction.Logistic regression analysis confirmed that multiparity was the protective factor of perineum incision,while amniotic fluid properties,prolonged time of the second stage of labor and shoulder dystocia were the risk factors of perineum incision (P<0.05).Conclusion:During delivery,we should strengthen the observation of amniotic fluid properties,pay close attention to the progress of the second stage of labor,improve midwifery skills to reduce shoulder dystocia,avoid routine perineum incision,and maintain maternal perineum integrity.

关 键 词：阴道分娩 会阴切开 影响因素 LOGISTIC回归分析 

分 类 号：R714.3[医药卫生—妇产科学]