改良平产会阴侧切术切口及麻醉方法的研究及应用  

Clinical study and application of the improved episiotomy incision and anesthesia method in the vaginal deliveries

作　　者：董立芹[1] 林华丽[1] 宋振兰[1] 

机构地区：[1]烟台毓璜顶医院,山东烟台264000

出　　处：《齐鲁护理杂志》2004年第1期1-3,共3页Journal of Qilu Nursing

摘　　要：目的 :评价改良的平产会阴侧切术切口及麻醉方法的临床应用效果。方法 :随机将 2 6 0例产妇分为观察组与对照组 ,各 130例。观察组根据胎儿体重及会阴体长度自会阴后联合中线或会阴 5点左右处作为切口起点 ,采取 15～ 4 0度 ,2～ 4cm长的左斜侧切法。切开时于切口部位行浸润麻醉 ,缝合皮下组织及肌层时行沿切口两侧内缘放射状浸润麻醉 ,缝皮时将麻药喷洒于切口分次麻醉。对照组以会阴后联线中点作为切口起点 ,≥ 4 5度 ,4～ 5cm长的左斜侧切法 ,施行阴部神经阻滞麻醉。观察指标均为切口缝合时的疼痛程度 ,72h活动程度 ,切口甲级愈合率 ,4 2d的切口情况等。结果 :观察组缝合切口时疼痛分级明显低于对照组 (P <0 0 0 1) ;产后 72h活动程度 ,切口甲级愈合率 ,产后 4 2d随访产妇状况均明显好于对照组 (P <0 0 0 1,P <0 0 0 5 )。结论 :改良的平产会阴侧切手术切口及麻醉方法符合生理要求 ,临床应用效果明显优于传统会阴侧切术。Objective:To investigate the effectiveness of the improved episiotomy anesthesia in the eutocia puerpera.Method:Two hundred and sixty full term were randomly divided into improved group and control group,and 130 puerpera for each group respectively.Side-cut was performed in (15～40)° at 5 o'clock and the length of incision was about 2～4cm according to fetal weight and length of perineal body in the improved group.Local infiltration of incision was used before outing,while suturing subcutaneous tissue and myometrium with radiantly infiltration from the incision was used and anesthetic was sprayed on the incision while suturing skin.Local infiltration of pudendal nerve was performed and side-cut in perineum was routinely carried out in 45° in the control group.Operative pain degree,movement within 72 hours after delivery,healing of incision were observed.Result:The operative pain was obviously less in the improved group than that in the control group(P<0 001).The movement within 72 hours after delivery,healing of incision within 72 hours and 42 days after delivery were better in the improved group than those in the control group(P<0 001,P<0 005).Conclusion:The improved episiotomy and anesthesia are reasonable new techonology.It was effective in reducing operative pain and improving the life quality of the puerpera.

关 键 词：麻醉 会阴侧切术 产科 手术 临床资料 

分 类 号：R719[医药卫生—妇产科学] R473.71[医药卫生—临床医学]