大黄芒硝外敷联合徒手淋巴引流对产后会阴水肿的疗效研究  

Therapeutic effect of rhubarb and mirabilite combined with manual lymphatic drainage on postpartum perineal edema

作　　者：薛莉莉[1] 徐淑琳[1] 蒋雅琼[1] 王小钰 陈丽平[1] Xue Lili;Xu Shulin;Jiang Yaqiong;Wang Xiaoyu;Chen Liping(Department of Obstetrics,Nantong University Second Afiliated Hospital/Nantong First Peoples Hospital,Nantong Jiangsu 226001,P.R.China)

机构地区：[1]南通市第一人民医院/南通大学第二附属医院产科,江苏南通226001

出　　处：《中国计划生育和妇产科》2024年第10期51-54,59,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：南通市卫生健康委员会科研课题(项目编号:MS2022016)。

摘　　要：目的分析大黄芒硝外敷联合徒手淋巴引流(MLD)对产后会阴水肿患者症状改善以及白细胞计数的影响。方法选取2021年10月至2023年7月在南通市第一人民医院产科经阴道分娩产后会阴达到I度水肿及以上的产妇120例作为研究对象,按照随机数字表法分为观察组和对照组,每组各60例。对照组采取常规护理+50%硫酸镁溶液湿敷,观察组在常规护理的基础上,给予大黄芒硝会阴外敷+MLD技术护理;记录并比较两组会阴恢复情况、临床疗效、会阴疼痛程度、生活质量评分、阴道分泌物指标、血清炎症指标以及产后并发症情况。结果观察组水肿消退时间以及伤口愈合时间短于对照组,会阴水肿临床总有效率(100.00%)高于对照组(88.33%),差异有统计学意义(P<0.05);治疗7 d后,两组视觉模拟评分法(VAS)评分下降,生活质量(QOL)评分升高,且观察组VAS评分低于对照组,QOL评分高于对照组(P<0.05);两组白细胞计数(WBC)水平以及pH值下降,乳酸杆菌、过氧化氢水平升高,且观察组WBC水平以及pH值低于对照组,乳酸杆菌、过氧化氢水平高于对照组(P<0.05);两组降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平下降,且观察组低于对照组(P<0.05);观察组产后并发症发生率(20.00%)低于对照组(36.67%),差异有统计学意义(P<0.05)。结论中药大黄芒硝外敷+MLD对产后会阴水肿疗效显著,能够有效降低患者疼痛和炎症反应,改善阴道微生态环境,缩短水肿消退以及伤口愈合时间,提高患者生活质量,减少并发症。Objective To analyze the impacts of external application of rhubarb and mirabilite combined with manual lymphatic drainage(MLD)on the symptoms improvement and white blood cell count in patients with postpartum perineal edema.Methods A total of 120 postpartum women with perineal edema of grade I or above after vaginal delivery in the Department of Obstetrics of Nantong First People's Hospital from October 2021 to July 2023 were collected as the study subjects.They were diveded into the observation group and the control group according to the random number table method,with 60 cases in each group.The control group received routine care and wet compress with 50%magnesium sulfate solution,based on routine care,observation group was given perineal external application of rhubarb and mirabilite combined with MLD technology care.The recovery of perineum,clinical efficacy,degree of perineal pain,quality of life scores,vaginal discharge indicators,serum inflammation indicators,and postpartum complications were recorded and compared between the two groups.Results The edema regression time and wound healing time in observation group were obviously shorter than those in control group,the total clinical effective rate of perineal edema in the observation group(100.00%)was higher than that in the control group(88.33%),and the difference was statistically significant(P<0.05);after 7 days of treatment,the visual analogue scale(VAS)score decreased and the quality of life(QOL)score increased in both groups,and the VAS score of the observation group was lower than that of the control group,while the QOL score was higher than that of the control group(P<0.05);the white blood cell count(WBC)level and pH value of the two groups were decreased,while the levels of lactobacilli and hydrogen peroxide were increased,the WBC level and pH value of observation group were lower than control group,while the levels of lactobacilli and hydrogen peroxide were higher than those in the control group(P<0.05);the levels of procalcitonin(PCT)and hypers

关 键 词：大黄芒硝 徒手淋巴引流 产后 会阴水肿 白细胞计数 

分 类 号：R714.46[医药卫生—妇产科学]