以会阴中心腱紧张度为标准控制胎头娩出速度在自然分娩初产妇中的应用  

Application of Controlling Fetal Head Delivery Speed Based on Perineal Central Tendon Tension as a Standard in Primiparous Women Undergoing Natural Delivery

作　　者：邱天爽 肖丹 吕春秀 李木子 肖一然 QIU Tianshuang;XIAO Dan;LYU Chunxiu;LI Muzi;XIAO Yiran(Department of Gynaecology and Obstetrics,Beijing Huairou Hospital,Beijing 101400,China;不详)

机构地区：[1]北京怀柔医院妇产科,北京101400

出　　处：《中国医学创新》2024年第9期88-92,共5页Medical Innovation of China

摘　　要：目的:探讨自然分娩初产妇以会阴中心腱紧张度为标准控制胎头娩出速度的应用效果。方法:选取2022年5月—2023年4月在北京怀柔医院进行自然分娩的产妇共计106例,以随机数字表法分成研究组(53例)与对照组(53例),两组均控制胎头娩出速度,对照组以每次用力时胎头露出阴道外口直径<1 cm为标准,研究组以会阴中心腱紧张度为标准,比较两组分娩时间、会阴裂伤情况、疼痛程度、分娩出血量、母婴结局。结果:研究组胎头拨露至娩出时间、第二产程均短于对照组,差异均有统计学意义(P<0.05),两组第三产程比较差异无统计学意义(P>0.05);研究组会阴裂伤程度较对照组更轻,差异有统计学意义(P<0.05);研究组胎儿娩出时、产后2 h时的疼痛程度数字评分法(NRS)评分均较对照组更低,差异均有统计学意义(P<0.05);研究组产时、产后2 h出血量均较对照组更少,差异均有统计学意义(P<0.05);研究组不良母婴结局发生率(3.77%)较对照组(16.98%)更低,差异有统计学意义(P<0.05)。结论:在自然分娩初产妇中以会阴中心腱紧张度为标准控制胎头娩出速度,能够缩短分娩时间,减轻会阴裂伤及分娩疼痛,降低分娩出血量,改善母婴结局。Objective:To explore the application effect of using perineal central tendon tension as a standard to control the speed of fetal head delivery in primiparous women undergoing natural childbirth.Method:A total of 106 primiparous women from May 2022 to April 2023 who underwent natural childbirth in Beijing Huairou Hospital were selected and randomly divided into the study group(53 cases)and the control group(53 cases).Both groups controlled the delivery speed of the fetal head,while the control group used the diameter of the fetal head exposed to the vaginal opening<1 cm during each force application as the standard,and the study group used the tension of the perineal central tendon as the standard.The delivery time,perineal injury,pain level,delivery bleeding volume and maternal and infant outcomes of the both groups were compared.Result:The time from exposure of fetal head to delivery and second stages of labor in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05),there was no statistically significant difference in the third stage of labor between the both groups(P>0.05).The degree of perineal injury in the study group was milder than that in the control group,the difference was statistically significant(P<0.05).The NRS scores of the study group during fetal delivery and 2 hours postpartum were lower than those of the control group,the differences were statistically significant(P<0.05).Bleeding during childbirth and 2 hours postpartum in the study group were less those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse maternal and infant outcomes in the study group(3.77%)was lower than 16.98%in the control group,the difference was statistically significant(P<0.05).Conclusion:Controlling the speed of fetal head delivery based on the tension of the perineal central tendon in natural childbirth primiparous women can shorten delivery time,reduce perineal laceration and delivery pain,reduce delivery ble

关 键 词：自然分娩 初产妇 会阴中心腱紧张度 控制胎头娩出速度 会阴裂伤 母婴结局 

分 类 号：R714.3[医药卫生—妇产科学]