不同指法着力点的会阴保护技术对初产妇分娩结局的影响  

Effect of varied perineal protection technique with different finger placement methods on delivery outcomes of primipara

作　　者：平燕 樊雪梅 周春秀[1] 李六兰 叶宁[1] 刘婧岩 支军 周文胜 Ping Yan;Fan Xuemei;Zhou Chunxiu;Li Liulan;Ye Ning;Liu Jingyan;Zhi Jun;Zhou Wensheng(Delivery Room,Women′s Hospital of Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院产房,江苏南京210004 [2]南京医科大学附属妇产医院门诊,江苏南京210004

出　　处：《护理学杂志》2024年第10期51-53,58,共4页Journal of Nursing Science

基　　金：国家自然科学基金资助项目(青年科学基金项目)(72204123)。

摘　　要：目的探讨2种指法保护着力点的会阴保护技术对初产妇分娩结局的影响。方法将329例经阴道分娩的初产妇随机分为观察组165例和对照组164例。对照组以距离会阴后联合2 cm处为指法着力点进行适度会阴保护,观察组以胎儿额骨最高点与会阴中心腱交汇点为指法着力点进行适度会阴保护。比较两组第二产程时间、会阴裂伤程度、伤口缝合时间、产后2 h出血量、产后24 h会阴水肿情况、产后48 h会阴疼痛程度及新生儿Apgar评分。结果观察组会阴裂伤程度、伤口缝合时间、产后2 h出血量、产后48 h会阴疼痛程度显著低于对照组(均P<0.05);两组产妇第二产程时间、产后24 h会阴水肿程度、1 min新生儿Apgar评分比较,差异无统计学意义(均P>0.05)。结论以胎儿额骨最高点与会阴中心肌腱交汇点为指法着力点的适度会阴保护技术能有效保护会阴,降低会阴损伤程度,提升产妇产后舒适度。Objective To explore the effect of moderate perineal protection technique with two fingers protection points on delivery outcomes of primipara.Methods A total of 329 cases of vaginal delivery were randomized into 165 cases in an experimental group and 164 cases in a control group.In the experimental group,the highest point of the frontal bone of the fetus and the intersection of the perineal central tendon was used as the point of focus for moderate perineal protection,while in the control group,the point of focus was 2 cm away from the posterior perineal coalition for moderate perineal protection.The duration of the second stage of labour,degree of perineal laceration,wound suture time,haemorrhage at 2 hours postpartum,oedema at 24 h postpartum,wound pain at 48 hours postpartum and the Apgar score of newborns 1 min were compared between the two groups.Results In the experimental group,the degree of perineal laceration,the time of wound suture,the amount of bleeding 2 hours after delivery,and the degree of perineal pain 48 hours after delivery were significantly lower than those in the control group(all P<0.05).There were no significant differences in the second stage of labor,the degree of perineal edema 24 h after delivery,and the Apgar score of newborns 1 min between the two groups(all P>0.05).Conclusion The moderate perineal protection technique using the intersection of the highest point of the fetal frontal bone and the perineal central tendon as the focus point can effectively reduce perineal injuries and increase the comfort of primipara in the postpartum period.

关 键 词：初产妇 阴道分娩 胎儿额骨 会阴中心腱 会阴保护 指法保护 会阴损伤 产科护理 

分 类 号：R473.71[医药卫生—护理学]