会阴Ⅱ~Ⅳ度裂伤相关因素分析  

Analysis of related factors for the puerpera with perineal Ⅱ~Ⅳ degree laceration

作　　者：孙磊[1] 王长虹[3] 杨敬改 孔翠花[2] 赵晔[2] 李迎军[3] 米立芬 李燕[1] SUN Lei;WANG Changhong;YANG Jinggai(Department of Delivery Room,The Second Affiliated Hospital of Xingtai Medical College,Hebei,Xingtai 054000,China;不详)

机构地区：[1]邢台医学高等专科学校第二附属医院产房,河北省邢台市054000 [2]邢台医学高等专科学校第二附属医院产科,河北省邢台市054000 [3]邢台医学高等专科学校临床系,河北省邢台市054000

出　　处：《河北医药》2021年第6期872-875,共4页Hebei Medical Journal

基　　金：邢台市科技支撑计划自筹项目(编号:2018ZC209)。

摘　　要：目的探索会阴Ⅱ~Ⅳ度裂伤的相关因素,为预防Ⅱ~Ⅳ度会阴裂伤提供依据。方法对邢台医学高等专科学校附属二院2018年1月至2020年6月经阴道分娩的946例产妇进行回顾性分析,采用logistics分析产妇情况、新生儿情况及其他情况对会阴Ⅱ~Ⅳ度裂伤的影响。结果会阴Ⅱ~Ⅳ度裂伤者达16.1%,以会阴Ⅱ度裂伤为主,占总裂伤的93.4%,会阴Ⅲ度裂伤占5.9%;会阴Ⅳ度裂伤占0.7%。会阴弹性差(β=0.853,OR=2.347,95%CI:1.573~3.502)、急产(β=0.418,OR=1.519,95%CI:1.113~2.072)、分娩时助产(β=1.164,OR=3.202,95%CI:1.081~9.489)、肩难产(β=0.720,OR=2.054,95%CI:1.314~3.209)、巨大儿(β=1.875,OR=6.519,95%CI:2.196~19.356)、产妇不配合(β=0.361,OR=1.435,95%CI:1.092~1.886)是会阴Ⅱ~Ⅳ度裂伤的危险因素(P<0.05);经产妇(β=-0.573,OR=0.564,95%CI:0.491~0.647)和助产人员工作时间长(β=-0.031,OR=0.969,95%CI:0.946~0.993)是会阴Ⅱ~Ⅳ度裂伤保护因素(P<0.05)。结论会阴Ⅱ~Ⅳ度裂伤的相关因素有产次、会阴弹性、是否急产、分娩时是否助产、肩难产、新生儿体重情况、产妇配合情况、助产人员情况。Objective To investigate the related factors for the puerpera with perinealⅡ~Ⅳdegree laceration in order to provide the basis for its prevention.Methods The clinical data about 946 puerpera who underwent vaginal delivery in our hospital from January 2018 to June 2020 were retrospectively analyzed.The effects of maternal situation,neonatal situation and other situation on the perinealⅡ~Ⅳdegree laceration were analyzed through Logistics analysis.Results The puerpera with perinealⅡ~Ⅳdegree laceration accounted for 16.1%,of whom,those with perinealⅡdegree laceration accounted for 93.4%,and those with perinealⅢdegree laceration accounted for 5.9%,and those with perinealⅣdegree laceration accounted for 0.7%.The poor elasticity of perineum,precipitate labor,assisted delivery during delivery,shoulder dystocia,fetal macrosomia,maternal imparity were the risk factors of perinealⅡ~Ⅳdegrees laceration(P<0.05).However the multigravida and the long working hours in midwives were the protective factors of perinealⅡ~Ⅳdegree laceration(P<0.05).Conclusion The related factors in puerpera with perinealⅡ~Ⅳdegree laceration are parity,elasticity of perineum,precipitate labor,assisted delivery during delivery,shoulder dystocia,weight of neonatus,maternal cooperation condition and midwife’s status.

关 键 词：会阴裂伤 分娩 相关因素 

分 类 号：R714.46[医药卫生—妇产科学]