会阴保护预测评分表的构建与验证  

Construction and verification of perineal protection prediction and scoring scale

作　　者：郑颖[1] 马秀娟[1] ZHENG Ying;MA Xiujuan(Department of Obstetrics,Chongqing Municipal Ninth People′s Hospital,Chongqing 400700,China)

机构地区：[1]重庆市第九人民医院产科,400700

出　　处：《重庆医学》2021年第16期2774-2778,2782,共6页Chongqing medicine

摘　　要：目的制订会阴保护预测评分表,为会阴保护助产提供有效的循证依据。方法选取2014年3月至2017年3月在本院分娩的378例健康产妇,通过《会阴保护影响因素调查问卷表》收集临床数据,分析会阴损伤影响因素(包括主观因素、客观因素)。制订会阴保护预测评分表,并评价其信效度。结果导乐分娩(OR=8.993,P=0.003)、孕期盆底肌肉训练(OR=3.853,P=0.050)、产次(OR=11.279,P=0.001)、第二产程时长(OR=10.691,P=0.001)、胎儿估计体重(OR=23.025,P<0.001)、会阴组织弹性(OR=18.927,P<0.001)、会阴水肿(OR=11.479,P=0.001)是选择性会阴侧切的指导因素。制订会阴保护预测评分表,总Cronbach′sα系数为0.723;Spearman相关分析显示,评估结果一致性好(r=0.946,P<0.001);因子分析显示KMO=0.660,P<0.001;86%以上条目的最大载荷系数大于0.4。结论依据选择性会阴侧切的指导因素制订会阴保护预测评分表,具有良好的信度和效度,可为会阴侧切提供依据。Objective To establish the perineal protection prediction scoring scale,and to provide an effective evidence-based basis for perineum protection for midwifery.Methods A total of 378 healthy parturients delivered in this hospital from March 2014 to March 2017 were selected.The clinical data were collected through the questionnaire of influencing factors of perineum protection,and the influencing factors of perineum injury(including subjective factors and objective factors)were analyzed.The perineal protection prediction scale was formulated.Its reliability and validity were evaluated.Results The doula delivery(OR=8.993,P=0.003),pelvic floor muscle training during pregancy(OR=3.853,P=0.050),parity(OR=11.279,P=0.001),duration of second stage of labor(OR=10.691,P=0.001),estimated fetal weight(OR=23.025,P<0.001),elasticity of perineum tissue(OR=18.927,P<0.001),and perineum edema(OR=11.479,P=0.001)were the guiding factors of selective episiotomy.The perineal protection prediction scale was formulated.The total Cronbach′sαcoefficient was 0.723;the Spearman correlation showed that the evaluation results had good consistency(r=0.946,P<0.001);the factor analysis showed KMO=0.660,P<0.001;the maximum load coefficient in more than 86%of items>0.4.Conclusion According to the guiding factors of selective perineal lateral incision,the score scale for perineal protection prediction is formulated,which has good reliability and validity,and can provide a basis for perineal lateral incision.

关 键 词：会阴保护 会阴侧切 预测评分表 信度 效度 

分 类 号：R717[医药卫生—妇产科学]