拆台正面坐位联合会阴无保护助产在低危型初产妇自然分娩中的应用效果  

The effect of stage removal frontal sitting midwifery combined with unprotected perineal midwifery in natural delivery of low-risk primiparas

作　　者：程莎莎 CHENG Shasha(Department of Gynaecology and Obstetrics,Medical Srvice Community,the Third People's Hospial,Luqiao District,Taizhou 318056,Zhejiang,China;Department of Obtetrics,Taizhou Enze Medical Center(Group)Enze Hospital,Taizhou 318050,Zhejiang,China)

机构地区：[1]台州市路桥区第三人民医院医疗服务共同体妇产科,浙江台州318056 [2]台州恩泽医疗中心(集团)恩泽医院产科,浙江台州318050

出　　处：《中国性科学》2022年第5期113-117,共5页Chinese Journal of Human Sexuality

摘　　要：目的探讨拆台正面坐位联合会阴无保护助产在经阴道分娩的低危型初产妇自然分娩中的应用效果。方法选取2016年4月至2017年3月台州恩泽医疗中心(集团)恩泽医院收取的364例经阴道分娩的低危型初产妇作为研究对象。根据随机数字原则分为传统助产组(n=121)、会阴无保护组(n=123)与拆台+会阴无保护组(n=120)。分析不同助产方式对产妇产程、产后并发症、会阴损伤、会阴疼痛、新生儿情况及产妇盆底肌功能的影响。结果三组第二产程、产后出血量及产后发热、尿潴留的发生率比较,差异无统计学意义(P>0.05);会阴无保护组、拆台+会阴无保护组产时出血量少于传统助产组,会阴完整比例高于传统助产组,差异具有统计学意义(P<0.05);三组会阴损伤及会阴疼痛程度比较,差异具有统计学意义(P<0.05);三组新生儿Apgar评分(1min、5min)及头皮血肿、窒息的发生率比较,差异无统计学意义(P>0.05);拆台+会阴无保护组新生儿开始含接乳头时间及开始吸吮时间短于传统助产组、会阴无保护组,差异具有统计学意义(P<0.05);三组产后6周时盆底肌力异常发生率及盆底肌异常种类构成比比较,差异无统计学意义(P>0.05)。结论拆台正面坐位联合会阴无保护助产可以减轻产妇会阴损伤,使新生儿尽早开始含接乳头和吸吮。Objective To analyze the effect of stage removal frontal sitting midwifery combined with unprotected perineal midwifery in natural delivery of low-risk primiparas.Methods Low-risk primiparas who had vaginal delivery in Taizhou Enze Medical Center(Group)Enze Hospital from April 2016 to March 2017 were selected as the research objects.According to the principle of random numbers,they were divided into the traditional midwifery group,the unprotected perineal group,and the stage removal+perineal unprotected group.To analyze the effects of different midwifery techniques on puerperal process and postpartum complications,injury and pain,neonatal condition and pelvic floor muscle function.Results There were no statistically significant differences in the duration of the second labor,the amount of postpartum bleeding,the incidence of postpartum fever and urinary retention among the traditional midwifery group,the perineal unprotected group and the stage removal+perineal unprotected group(P>0.05).The amount of bleeding during delivery in the unprotected perineal group and the stage removal+perineal unprotected group was less than that in the traditional midwifery group(P<0.05),and the proportion of perineal integrity in the unprotected group and the stage removal+perineal unprotected group was higher than that in the traditional midwifery group(P<0.05).Pairwise comparison between the traditional midwifery group,the unprotected perineal group and the stage removal+perineal unprotected group showed statistically significant differences in perineal injury and perineal pain(P<0.05).There were no significant differences in neonatal Apgar score(1 min,5 min)and the incidence of scalp hematoma and asphyxia among the three groups(P>0.05).In the stage removal+perineal unprotected group,the time for the newborn to receive nipples and start suction was shorter in the traditional midwifery group and the unprotected perineum group(P<0.05).There was no significant difference in the incidence of abnormal pelvic floor muscle strength and t

关 键 词：拆台正面坐位助产 会阴无保护助产 初产妇 阴道分娩 

分 类 号：R714[医药卫生—妇产科学]